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.
Average unbilled revenue identified per client, per year
140+ FTE research experts
Create, maintain and edit rules
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.
Claims Manager gives our organization the ability to review claims before submission so our staff can see and correct errors themselves.– Coding Director