SubHero Banner
Text

Claims for payer-provider connectivity

Text

Achieve claims accuracy before submission

Optum360® uses an expansive knowledge base of payer regulations and industry guidelines to drive claims edit logic. It automatically flags certain-to-deny claims and unbilled services before submission. This helps shorten accounts receivable cycles and maximize revenue.

Driven by more than 132 million code-to-code relationships, the Optum® Knowledge Base pre-screens claims for clinical coding and billing errors. Its consistent, automated edits help you comply with Medicare, Medicaid and commercial payers.

Maintained by a team of 140 industry experts, our rules engine is the result of more than a decade of investment and refinement. Our unmatched technology and experience can help you simplify claims management, capture missed revenue and strengthen your bottom line.

Text

bill icon

$1.54 million

Average unbilled revenue identified per client, per year

Text

computer screen icon

132 million

Code-to-code relationships

Text

pencil icon

140+ FTE research experts

Create, maintain and edit rules

Color Block

Text

Prevent clinical and coding denials

See how Optum Claims Manager creates a reliable and consistent approach for processing claims. Learn about this proactive system that can identify unbilled items and certain-to-deny claims based on payer adjudication.

 

Text
Text
Text

Claims Manager gives our organization the ability to review claims before submission so our staff can see and correct errors themselves.

– Coding Director
Color Block

Text

Start the conversation

The path to a denial-free future is possible with the right partner. Our flexible engagement model can adjust to match your organizational needs.

Contact us online

Text
Text
Text