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The Optum Coding Review Module is a component of Optum CAC Professional that automatically compares physician-selected codes to natural language processing (NLP) code assignments. 

It applies advanced clinical intelligence to identify coding misalignment and enable improvement.

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Benefits

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Automates physician-selected coding review

  • Enables more complete and accurate coding without additional staff
  • Provides configurable business rules and customized workflows
  • Leverages Optum NLP to accurately identify encounters needing review
  • Performs prospective review to allow real-time correction

Enables targeted action

  • Identifies problem areas where physician education is indicated
  • Allows you to target specific encounter and patient types
  • Helps quantify the effectiveness of your quality program
  • Offers flexibility to address specific areas of concern

Improves coding accuracy

  • Provides secondary review of physician-coded encounters
  • Identifies discrepancies between NLP- and physician-selected codes
    • Enables efficient review and modification prior to billing
    • Reduces denials and rework
    • Preserves revenue
    • Mitigates payer audit risk
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The path to a denial-free future is possible with the right partner. Our flexible engagement model can adjust to match your organizational needs.

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