Optum Claims Manager Facility

Optum® Claims Manager Facility identifies certain-to-deny claims and unbilled services by prescreening for clinical coding relationships and billing errors, based on payer adjudication. Practices using Claims Manager leverage a collaborative, unified platform with advanced clinical editing capabilities to help shorten accounts receivable cycles and maximize revenue.

Optum Claims Manager Facility helps your organization:

  • Correct claims at the least costly point — before they leave your system
  • Proactively identify missed revenue for unbilled services
  • Reduce denial rates and administrative expenses due to incorrect coding
  • Take advantage of a consistent, automated standard to comply with government and commercial regulations
  • Configure current system rules and create your own custom edits in minutes to meet billing and reimbursement needs

Powerful content and rules-based editing

The Optum KnowledgeBase powers Claims Manager with more than 130 million code-to-code relationships to prescreen claims. Combined with your custom edits, this rules-based tool helps ensure your organization has the content and insights to receive timely reimbursement and make better business decisions.

The KnowledgeBase is maintained by a team of 140 clinical and technical experts who ensure clients receive precise regulatory updates related to Medicare, national and state-specific Medicaid and commercial guidelines.

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For information about an Optum360 solution for your business please complete the form below. To speak with us sooner call 1-866-223-4730 or email Optum360@optum.com.

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