Revenue Cycle Transformation
Ending administrative waste in health care
See how our financial ecosystem connects all parties.
- [Narrator] The US healthcare system suffers from 200 billion dollars of administrative waste annually, with inefficiency between payers and providers at the root and consumers caught in the middle. Optum360 is creating a financial ecosystem that's connected, fostering collaboration between payers and providers, while improving the consumer financial experience. We consolidate data from disparatete EMR systems, harmonizing it for a better documented claim, and use our clinically aware natural language processing to find data that supports the revenue cycle decision making process. Here, Mary arrives at the ER with breathing trouble. She's admitted with a history of COPD. Her work-up creates dozens of documents from different clinicians, while artificial intelligence finds data in her record to support a hospital admission. Within seconds, key markers from Mary's medical history, physical exam, and chest x-ray trigger the documentation needed for reimbursement. The claim is paid. Administrative costs are saved, and Mary is spared financial stress. In this modern exchange, hospitals realize a 94% payer acceptance rate for in-patient recommendations. Many clients see a 20 to 30% improvement in time to bill, and CMS Medicare Administrators report 31% fewer suspended or denied claims. With Optum360 cash flow accelerates, denials decline, waste diminishes. And most importantly, people like Mary have a better financial experience.
A transformation like this doesn’t happen overnight. So far, we've increased our EBITDA by millions with improved processes and efficiency.– Daniel Morissette, Sr. Executive Vice President/CFO, Dignity Health See success story