Optum Claims Manager Professional
Optum® Claims Manager Professional 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 Professional 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.