Revolutionizing Utilization Review
Optum360 offers physician advisor expertise, evidence-based medical research and artificial intelligence to support appropriate reimbursement and accurate quality reporting within your organization. We team up with your physicians to pinpoint improvement opportunities.
Our on-site and remote services can apply artificial intelligence to drive timely patient-status determinations. We deliver greater efficiency, accuracy and integrity to your utilization review and clinical documentation improvement processes and outcomes.
Our Physician Advisor Solutions can help you reduce denial rates, manage appeals, minimize audit risk and optimize reimbursement.
Value of the AI-powered service model
Effective use of clinical resources
A smarter, holistic UR process for comprehensive caseload review
Predictive insights for improved status accuracy
Improved Optum360 investment value
Are you ready to join the revolution?
- Proper review of all cases
- Reduce denials
- Achieve appropriate reimbursement
improvement on patient status accuracy
estimated annualized proper reimbursement improvement
in denial rates
The evolving role of utilization review
Explore the challenges of utilization review and strategies to achieve proper reimbursement.
Addressing Commercial Denials
Address your commercial denials with a clinical perspective.