CAC, combined with advanced NLP, is the future of coding technology....
It is estimated that preventable readmissions for Medicare patients cost the federal health care trust fund about $17.5 billion each year....
To mitigate revenue loss and manage accounts receivable (A/R), hospital finance leaders describe how they are making ICD-10 denials management a top o...
Learn how Optum and UPMC are automating clinical documentation improvement with impressive results....
Steward Health Care System ramps up Optum™ Population Health Management solutions for an immediate impact while building their ACO....
Best practices for physician-based population health management...
This white paper examines areas in which outsourced revenue cycle management arrangements can be beneficial, and the key points organizations should c...
Part two of this ongoing series reveals Bethesda's success with managing and preventing denied claims, improving patient collections, and curtailing f...
To help health care providers and payers prepare for ICD-10, Optum has prepared the answers to frequently asked questions....
Combining Optum's eFR Platform with Lean process improvement, Norwalk Hospital achieved substantial results, reducing A/R days, aged receivables, and ...
Adirondack Radiology Associates (ARA) is the premier radiology group in the North Country of upstate New York, which includes Warren, Washington, and ...
DCH Health System in Tuscaloosa, Ala., eliminated manual business office processes, automated workflow and gained insight with the Optum eFR Platform...
With the rising costs of healthcare, Bethesda Healthcare System (BHS), a not-for-profit, 401-bed health care organization serving South Palm Beach Cou...
The introduction of ICD-10-CM/PCS will result in a massive overhaul of the IT infrastructure that supports health care coding, billing, and claims man...
The people fighting fraud and abuse in medical claims have a tough challenge due to the current United States medical reimbursement system. Although t...
Clinical documentation improvement (CDI) is taking center stage, as physicians seek relevant information to improve patient care and payers inquire ab...
St. Vincent Health minimizes underpaid revenue, gains more visibility into contracts, and reduces cost and complexity with hosted version of Optum™ Co...
The Oct. 1, 2013 deadline for implementation of the ICD-10 code set is rapidly approaching. As organizations prepare, many are wondering if the switch...
The health care industry’s transition to the 5010 transaction standard generated a great deal of discussion about electronic data interchange (EDI). M...
In advance of the iHT2 Health IT Summit in Beverly Hills, Cynthia Kilroy, Senior Vice President of Provider Strategy and Business Development, Optum s...
Forward-thinking organizations can develop a strategic approach to accountable care by identifying unique partnerships. This whitepaper outlines key a...
The financial incentives offered through Medicare’s Physician Quality Repor ting System (PQRS) are an oppor tunity for today’s radiology practices to ...
As coders prepare for the complex transition to the ICD-10 code set, currently set for October 2014, more sophisticated coding technology is increasin...
There are good reasons that employers, brokers and consultants are taking a fresh look at Optum Reporting and Insights’ data and analytics solut...
Quality of data and the way that data is integrated and analyzed to improve results will be the key to innovation and the foundation for improvements ...
Universal concern about rising health care costs combined with historic health care legislation has created an unprecedented window of opportunity to ...
The healthcare industry has been abuzz for some time over the arrival of ICD-10-CM/PCS, the expanded diagnosis and procedure coding system that is set...
Optum Patient Statements Manager virtually eliminated document creation labor expenses which helped CHOC Pediatric Subspecialty Facility save one FTE ...
As health care organizations implement or expand the capabilities and reach of health information exchanges (HIEs), community and patient acceptance a...
As the need for health information exchange (HIE) to transform the health care system becomes more evident, the number of health information exchange ...
With the industry shift from fee for service to value-based reform, health plans must reassess every aspect of their approaches to provider network ma...
This survey was intended to capture respondents’ operational practices and outcomes with respect to large group medical insurance. It is intended that...
The ICD-10 implementation deadline has changed once again, delighting some stakeholders, while fueling frustration among others....
Optum has been identified as a sample vendor in the newly released Gartner “Hype Cycle for Healthcare Payers, 2012” report....
At Virginia Commonwealth University Health System (VCUHS), an initiative has been under way for a number of years that focuses on optimizing and stand...
Franciscan Health System, located in Washington state, wanted to streamline the delivery of its clinical results to affiliated physicians. It partnere...
As health care costs in the U.S. continue to spiral upwards, many health care organizations have begun focusing on the use of information technology i...
Optum™ Virtual Health Record is improving patient care and reducing costs for more than 1,400 physicians across Nebraska....
Health care payment reform certainly sounds good, but for organizations that provide patient care, it has the potential to be fraught with challenges....
During the last few years, much has been written about sustainable health information exchanges (HIEs). Even with the attention that this topic has re...
Prospective utilization of knowledge gained from root cause analysis leads to substantial savings....
One of the nation’s largest health insurance plans needed assistance analyzing its paid claims data to isolate the root causes of overpayments i...
In a never-ending quest to drive down administrative costs, leading health plans and provider networks periodically review their business functions fo...
Working in collaboration with Optum, Gwinnett Medical Center improved its financial performance as well as accountability, transparency, and processes...
Dr. Douglas Foreman improves patient care, becomes one of the first physicians to qualify for federal health IT incentives using Optum Physician EMR&r...
Optum® government solutions can help turn your state’s data into useful information and enable better decision-making for long-term sustainability of ...
DES MOINES, Iowa – An aggressive program integrity initiative for Iowa Medicaid saved taxpayers nearly $30 million in cost avoidance or recoveri...
SPRINGFIELD, Ill., July, 17, 2012 – The State of Illinois will expand its use of advanced technology to manage Medicaid and human services funct...
OptumInsight and one of its key government clients, the State of Michigan, have collaborated to implement a data analysis and reporting tool to promot...
Bill Gwinn, Vice President, Clinical Informatics Solutions, OptumInsight, discusses best practices for finding the right patients and investigators fo...
Optum, in collaboration with the University of Pittsburgh Medical Center, is developing a CDI solution that will improve documentation to facilitate t...
Clinformatics for Clinical Trials Demonstration Video....
Lean and Six Sigma are helping hospital executives improve revenue cycle efficiency and payment accuracy as described in this report featuring leaders...
Electronic patient statements cost analysis...
Cash-strapped state Medicaid programs should focus on dramatically reducing the incidence of adverse birth outcomes as a way to potentially cut tens o...
This white paper summarizes an assessment approach based on health plans self-rating seven critical market-validated network management dimensions. Th...
The Colorado Otolaryngology Associates (COA), PC facility was struggling to post payments in a timely fashion. Its manual payment posting process took...
Indiana University (IU) Health Bloomington Hospital, located near Indiana University in Southern Indiana, serves as the medical center for a significa...
MultiCare Health System used Optum Payment Mangement to eliminate its manual cash posting processes across its 93 locations, and now "operates in an ...
Axolotl, now OptumInsight, replaced the direct-attached storage devices that supported its SaaS solution with three tiers of shared Dell™ EqualLogic™ ...
Optum™ Reporting & Analytics deliver vital proof-of-value for successful pre-planning, financial modeling, and payer participation for Rochester (NY) ...
In mid 2010, Raritan Bay Medical Center began a year-long process of evaluating solutions and vendors that would help to ease the difficulty of accura...
OptumInsight™ is the first to facilitate a national credentialing coalition that coordinates the credentialing cycles of providers who affiliate...
This paper discusses physician incentive-to-performance linking systems (pay for performance or P4P) and Optum™ Impact Intelligence®, a medical inform...
Neutrality risk management is often thought of strictly in financial terms. With ICD-10 for example, payers will see no impact to their revenue, reimb...
The transition to ICD-10 has an impact across all functional areas, including medical management, claims, call centers, finance, providers, benefits a...
This whitepaper highlights best practices from some pioneering health care organizations and outlines guidelines for health care providers to take on ...
Where are the patients? Where are the investigators who have access to them? These are early questions in clinical trials, and it is hard to find the ...
Coding is in the middle of a five-year storm. In 2008, Medicare Severity DRGs (MS-DRGs) nearly doubled the number of DRGs and made severity of illness...
Health care organizations are focused on measuring the cost and quality of health care as a way to improve patient outcomes and overall value of servi...
Today's healthcare industry is currently experiencing a defining moment of its own: preparations for the transition to the International Classificatio...
A critical component of the Patient Protection and Affordable Care Act (PPACA) mandates the creation of public, state-run Health Benefit Exchanges (HB...
The purpose of this analysis is to quantify the potential financial savings that can be achieved through improved compliance with evidence-based guide...
Ted Hoy, senior vice president of Cloud Solutions at Optum, discusses the need for interoperable systems and more effective clinical data exchange dur...
CMS announced last month its anticipated list of the first 27 accountable care organizations selected for the Medicare Shared Saving Program. CEO Judy...
Do you hate to be late? Most people do, but many clinical trials run late, year after year. This article will address the major causes by demonstratin...
On May 18, 2012, Dr. Miles Snowden, Chief Medical Officer of Optum, presented at the World Congress Leadership Summit on ACOs in Washington, D.C. Watc...
On May 18, 2012, Dr. Miles Snowden, Chief Medical Officer of Optum, presented at the World Congress Leadership Summit on ACOs in Washington, D.C. Wat...
Computerized Management Services reduced their cycle time associated with the critical reconciliation process to less than 30 days....
Optum Computer-Assisted Coding (CAC) is powered by our proprietary and patented NLP engine, Optum LifeCode®. Optum CAC accelerates your coding process...
Read The Center for Digital Government's special report, featuring issues such as data, dashboards, and analytics....
Today, government technology is undergoing just a revolution. Historically, we have put the IT system at the center of our universe. But today’s new w...
In 2008, Sentara decided to leverage the internal IT expertise of Optum™ in conjunction with Sentara staff to develop an entirely new interface to all...
Capturing ED facility evaluation and management (E/M) visit level charge can be a daunting task, and one that required the time of 35 nurses at Medcen...
The Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) is announcing that it will not initiate enforcement act...
With the implementation of Accredited Standards Committee (ASC) X12 Version 5010, several concerns have been identified that may impact certain activi...
Although there are a wide variety of 5010-related issues causing claim errors and rejections, several issues are consistently listed as the top reason...
OptumInsight senior vice president for Government Programs Steven Wood will present the lunchtime keynote address at the 6th Annual Rise Summit a...
2012 ACO Summit...
In addition to the financial benefits, "Having on-site teams and operational teams [at multiple facilities] that can access the same data has really f...
DCH Health System in Tuscaloosa, Ala., eliminated manual business office processes, automated workflow and gained insight with the Optum eFR Platform....
Ohio Health is one organization already implementing ICD-10 changes. Because of concerns over coding productivity, the Columbus, OH-based health syste...
Optum's Accountable Care Solutions unit was recently featured in the Minneapolis/St. Paul Business Journal. Click here to view a reprint of this artic...
Those interested in understanding and improving the health care system have long used information in medical claims—bills submitted by physician...
Implementing a multidimensional, pre-payment fraud detection strategy can help health plans improve financial health and provide affordable, quality h...
Optum recently launched The Optum Institute for Sustainable Health, which will leverage the company’s broad health care experience and research ...
Deborah Marshall, MSHA, PhD, Associate Professor, Canada Research Chair, Dept. of Community Health Sciences, University of Calgary, Calgary, AB, Canad...
Michael Drummond, Mcom, DPhil, Professor of Health Economics, Centre for Health Economics, University of York, Heslington, York, UK, discusses value-b...
Alistair McGuire, PhD, Head of Social Policy, LSE Health and Social Care, London, UK, discusses rising health care costs around the globe, what contri...
At Optum, we not only share your passion for health care improvement, we are committedto being part of the solution. This inaugural issue offers indus...
On July 27, 2011, CMS released its 2012 star ratings measures, which added new measures and removed or recalibrated others. While there were few surpr...
CMS has announced the October 1, 2014 ICD-10 compliance date. Health plans should take advantage of the extra time and start ICD-10 testing today to e...
The Centers for Medicare & Medicaid Services (CMS) are raising the stakes in measuring whether Medicare Advantage plans are delivering quality car...
Watch this archived webinar to hear Miles Snowden, MD, MPH, CEBS review what a recent survey (sponsored by Optum and administered by Harris Interactiv...
Optum was among the sponsors of the recent Accountable Care and Health IT Strategies Summit in Miami. In this short video segment, Dr. Mark Crockett, ...
Dr. Bill Crown, President Commercialization, OptumInsight Life Sciences recently joined an industry panel of experts to discuss the industry’s s...
Ready or not, coding as we know it is about to change. The LifeCode® natural language processing (NLP) technology behind Optum’s CAC accurat...
Gwinnett Hospital System reduces DNFB days, increases case mix index (CMI), and improves coding accuracy, efficiency, and productivity....
Watch this archived webinar to hear Miles Snowden, MD, MPH, CEBS review what a recent survey (sponsored by Optum and administered by Harris Interacti...
Not all CAC tools are created equal. Understand the key elements of natural language processing and how the precision of Optum’s LifeCode NLP te...
New compliance practice white paper. For Medicare Advantage (Part C) Plans and Prescription Drug (Part D) Plans. There is no question that the stakes...
Dr. Marc Berger, executive vice president and senior scientist, Life Sciences, OptumInsight, discusses the importance of using different types of comp...
In this study we provide estimates of the program’s impact on coverage and spending for the federal government, state and local governments, pri...
Announcing a partnership between Tucson Medical Center and OptumInsight that will create a Sustainable Health Community....
Bethesda Healthcare System...
"We've been using CareTracker for over a year now... We got a painless transition and strong ROI." – Dr. Pablo Rodriguez President and CEO Wo...
Optum and UPMC have automated CDI with impressi...
DCH Health System in Tuscaloosa, Ala., elimina...
ICD-10: Big Changes Bring Big Opportunities.
Why Bethesda Chose Optum.
Announcing a partnership between Tucson Medical Center and OptumInsight that will create a Sustainable Health Community.
Bethesda Healthcare System
"We've been using CareTracker for over a year now... We got a painless transition and strong ROI."
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OptumInsight senior vice president for Government Programs Steven Wood will present the lunchtime keynote address at the ...
CMS has announced the October 1, 2014 ICD-10 co...
Link to external article on Health Data Management web site
Quality of data and the way that data is integrated and analyzed to improve results will be the key to innovation and the foundation for improvemen...
States can take several concrete steps to reduc...
The standard marketing value equation taught in business school states value equals utility or benefits less costs. Because the relationship betwee...
Bill Gwinn, Vice President, Clinical Informatics Solutions, OptumInsight, discusses best practices for finding the right patients and investigators...