Achieve accurate coding, appropriate reimbursement and correct quality metrics
Optum® Computer-Assisted Coding (CAC) Professional streamlines processes and drives accurate and efficient coding for the ambulatory health care market. Powered by Optum® natural language processing (NLP), CAC Professional automates workflow and performs intelligent code assignment for consistent, compliant coding, optimal operations and accurate revenue capture.
Value-based payment models are placing increasing pressure on physician organizations. They must accurately code for the care provided to maintain appropriate reporting, quality metrics and reimbursement. CAC Professional supports those goals by increasing coder accuracy and efficiency, applying built-in LCD and CCI edits and providing the information needed to assign appropriate E/M levels.
- Increases coding accuracy, productivity and consistency
- Improves compliance through traceability
- Supports MIPS quality measures reporting
- Decreases A/R days through increased straight-to-bill rates
- Reduces denials and missed revenue opportunities
- Expedites reimbursement through coding automation
Monitor physician-assigned codes
The Optum® Coding Review Module is a component of CAC Professional that compares physician-selected coding to NLP-assigned codes. Using configurable rules and customized workflows to identify specific or misaligned codes, it enables targeted action to improve coding accuracy, reduce risk, prevent denials and preserve revenue.
Automate and accelerate auditing
The Optum® CAC Audit Module works in conjunction with CAC Professional to automate and accelerate the medical record audit process. The Audit Module leverages Optum NLP and patent-pending algorithms based on OIG methodology and RAT-STATS to support complete and compliant coding. In addition, it allows you to set and measure accuracy goals, reduce audit risk and improve revenue capture.
Learn more about how Optum CAC Professional enables large physician practices, hospital-managed physicians and professional billing companies to hone coding and charge capture processes to reduce denial rates, accelerate payments and capture correct revenue.