Reimbursement

Protect reimbursement by achieving greater clarity

As ICD-10 takes effect, claims-processing delays, longer appeals and more denials are expected to result in inaccurate payments and slower cash flow for providers. Optum360™ reimbursement technology and services can help your organization protect revenue by providing the accuracy and clarity payers need to process your claims.

Optum360 Denial Management

Reimbursement for patient care can be unnecessarily delayed or eventually lost or written off because of claim denials. Optum360 Denial Management improves payment recovery by enabling providers to capture, identify, and correct the root causes of denied claims while improving productivity through intelligent, event-driven, automated workflow. Learn more.

Optum360 Revenue Cycle Management Services

Evolving payment methodologies and tight claims submission time lines present tremendous challenges as providers look to increase revenue. With Optum360 Revenue Cycle Management Services, our experts look across your entire revenue cycle to identify net revenue opportunities, helping you capture more accurate patient billing data, refine eligibility verification and make essential financial information accessible across your entire care community.

Payer Contract Analysis

Payer contracts are another area that could impact reimbursement during the shift to ICD-10. With our payer contract analysis, an Optum360 consultant will review your current contracts for clauses related to payers’ right to make changes, timely billing and late payments, and utilization and payment terms that could be affected by the transition. We will then recommend changes and can assist in your contracting and re-contracting strategy and negotiations.

Education and Training

With experience conducting ICD-10 business readiness assessments in health systems across the country, Optum360 has a deep understanding of providers’ ICD-10 education and training needs. Courses are available in eLearning and classroom formats. Supplemental training options include on-site train-the-trainer sessions to cultivate physician champions, courses designed to build more in-depth experience and support through medical records audits, and education during the dual-coding and post-transition phases of ICD-10 implementation. Learn more.  

Talk with an ICD-10 specialist. Call 866.223.4730.
 

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