Intuitive data dialogues create a smooth claims process.
Bring transparency to the conversation
Optum360® supports real-time communication and financial exchange between health systems and the groups that reimburse them. Automated sharing of clinical and claims data eliminates needless “back and forth” and administrative friction from payer-provider relationships.
Building data-sharing power into the revenue cycle improves transparency and efficiency across the entire care system. For providers and payers alike, that means smoother transactions, increased claims accuracy, reduced rework and predictable financial performance.
Employ a flexible information exchange across the revenue cycle
- Clinical and administrative information exchange
- Timely feedback loops on claim errors
- Standardized electronic health data
- Self-service claim administrative tools
Reduction in calls related to denied claims
Reduction in suspended/denied claims
Reduction in redetermination requests
A revenue cycle for collective success
Join us as Optum360 CEO Tom Boehning shares the vision of a sustainable denial-free health care system. One in which all partners collaborate in a common, connected and transparent financial exchange.
Speaker 1: 00:00 Ladies and Gentlemen, please welcome Vice President of Revenue Cycle Innovation Optum360, Jim Lazarus.
Jim Lazarus: 00:16 Good afternoon. Welcome to the 2018 Optum Forum and our Optum360 session, Modernizing the Revenue Cycle for our Collective Financial Success. I'm Jim Lazarus, Vice President for Revenue Cycle Innovation for Optum360 and we're here in Las Vegas with a live audience of over 500 clients and partners. For the next 30 minutes or so we'll hear perspectives from industry leaders on the payer side, the provider side, and talking about the challenges they're facing in today's complex and difficult health care environment. We'll also hear from Optum360 CEO about what Optum360 is doing to address these challenges.
Jim Lazarus: 00:51 Now, I joined Optum 360 late last year from the Advisory Board company where I spent 15 years leading our revenue cycle innovation work, doing our national partner over revenue cycle. And for those of you that know the Advisory Board, you know that we have a privileged position to really understand the challenges facing the provider community across the country in revenue cycle. Now, Optum360 has the opportunity to work with so many payers and so many on the payer side that really have this unique perspective now as a combined organization on the challenges, on the really complexities that we're addressing. And so before I invite some of our guests to come out in a few minutes, I want to spend five minutes and really summarize where do we sit all now, right here? You're here in Las Vegas, we're here to talk about our challenges, our work with Optum360 and what we're doing, where do we find ourselves?
Jim Lazarus: 01:39 First and foremost, the Advisory Board research has told us for years and it is more so true now than ever, we are facing a complex, challenging, and difficult environment overall and especially in the revenue cycle. When you look out across the challenges that we have in front of us, think about our performance metrics. Denials continue to grow over and over, we're seeing days in AR stagnate. Bad debt is starting now to creep back up after the reductions we saw from the ACA a few years ago. Providers are really struggling without the effective capabilities of technology and the tools they need to confront these growing challenges. Costs are up, inefficiencies are up as a result as well.
Jim Lazarus: 02:16 Now, for those of us that have grown up in the provider community, the payer is an easy villain and not necessarily always the wrong one in many instances. All right? Think about the proliferation of authorizations and precertifications. The skyrocketing initial denials that we've seen as an industry across the last three to four years alone. The lack of open communication, the lack of constructive dialogue and the consistent no one version of truth between provider and payer perspective. Even the difficulties engaged in our physicians in that conversation. But, if we're all honest with ourselves, we can't but it all on the foot of the payer. We have struggled in our own offices, our own health systems, to deal with the challenge that we have of inefficiencies, poor technology and a lack of innovation, and oftentimes failing to confront some of the biggest challenges that we have ourselves. Our bureaucracy, the complexity that we have overall and, frankly, engaging our physician and clinician partners in the important role that they play in overall revenue cycle.
Jim Lazarus: 03:16 So the result, as you think about it, is really an overwhelming challenge for many of us and this is despite the investments we have made an industry. Think back with me for the last five or ten or fifteen years, whatever your tenure is, think about how far we've come, how different our teams are, our tools are, what we're doing differently as an organization and yet we still find ourselves sitting in a room facing challenges as large and complex as we ever have beforehand.
Jim Lazarus: 03:43 Now, over the last few months I've gotten more and more exposure to our payer partners. And the reality is is that they're facing some of the same challenges. And there's actually one common area that we're beginning to see coalescence around, and that is the patient. All right? Think about it, the patient has emerged as one of the most challenging and new dynamics in our industry over the last four to five years especially. And we have to confront patients not simply as recipients of healthcare but now increasingly consumers who actively directing their healthcare, as well as their healthcare spend, and ultimately payers. As a matter of fact, Advisory Board research is just saying for the first time that patients now make up typically for most organizations the fourth or fifth largest payer overall.
Jim Lazarus: 04:29 When you think about the payer perspective, we have now a shared common constituency in our patients. And when I interview more and more payer organizations they actually say, remarkably, the same thing. Administrative costs are too high, inefficiencies are too, are too often embedded in our process and our system. We lack innovative tools, we lack the capabilities. We have difficulty communicating with the provider community. There is friction and tension throughout, which sounds familiar, I would imagine. The end result is that CMS estimates that there is 200 billion dollars of administrative waste in healthcare between payer and provider overall. We need engagement from both sides. From payers and from providers in coming to solve this really challenging problem. And so, for the next 30 or 35 minutes, we'll engage some of our industry leaders in taking on that exact problem and challenge.
Jim Lazarus: 05:24 So please welcome me in joining to the stage, Optum360 CEO Tom Boehning, Dignity Health Senior Vice President of Revenue Cycle and Finance Tim Panks, and Palmetto GBA Vice President of Operations Mike Barlow.
Jim Lazarus: 05:51 So, Mike, let's start with you. I think most in the audience are probably familiar with Medicare administrative contractors and what a MAC is, but Palmetto is one of the largest MACs in country representing almost 25% of all Medicare claims. Why don't you tell us a little bit about the role the MAC plays in this complex equation between provider and payer and specifically tell us a little bit about what op, you've done with Optum360 to innovate in that relationship.
Mike Barlow: 06:15 Well, the main thing we've done is, you know, as all MAC we have to administer the Medicare program. Medicare coverage rules, in general, very complicated, they're always changing. And trying to communicate that and, and get that to process through the claims systems can in fact be a challenge for providers and for us. It leads to unnecessary denials, nonpayments, to the just simple claim errors that we want to eliminate. And the standard messages that we can use when the claim system denies a claim are about as clear as a plain piece of paper. They don't tell you what's missing, what's wrong. They don't fix the problem. So Optum's advance communication agenda, or ACE, we saw as an opportunity to put that as the answer to the problem because we can take those rules, put them up front and actually edit the system, the claim, and tell the provider upfront what's wrong with the claim, what's going to cause it to deny. Give them the opportunity to fix it while it's still in the EDI stream. It stops those unnecessary denials, it shortens the revenue cycle tremendously from ... because providers can basically submit this morning, get a message this afternoon, and resubmit.
Mike Barlow: 07:26 And so we, we get a better handle and in the process those messages that send back educate the provider about the rule that was affecting that particular claim so we don't see that problem any further. So it stops the phone calls, it stops the appeals and it's starts the process of making the rules that we have to live with more transparent between us and the provider.
Jim Lazarus: 07:47 Delivering it earlier in the process.
Mike Barlow: 07:49 Yes.
Jim Lazarus: 07:49 So as we were preparing, you actually shared some of your results with, with me. Could you share it with the audience here? What have you seen?
Mike Barlow: 07:55 Well, the basics, you know, from an administrative standpoint is 31% reduction in suspense of claims. That means the claims are no longer stopping, they're going right on through to payment. And believe it or not, as a payer, I know providers don't believe this, we do want the claim to come in and go out the back door and never ever have to touch a human being.
Jim Lazarus: 08:14 This is being recorded.
Mike Barlow: 08:15 I know.
Jim Lazarus: 08:15 (Laughs).
Mike Barlow: 08:15 And then we also have a reduction in claim appeals because most appeals, at least in this space, are about claim errors, they're not about disagreements with the rules. They're just claim errors that we want them to fix through the appeals process. And it stops those phone calls of why did you deny my claim or why didn't you pay my claim because they now have messaging that tells them what, what needs to be corrected on the claim.
Mike Barlow: 08:40 And we've seen other changes from the process in terms of the, the Medicare program at least for the jurisdiction that we administer, has seen in those four years since we've been doing ACE over a half million dollars worth of value in terms of these claims that we're not having to touch anymore.
Jim Lazarus: 08:58 Did you say a half billion?
Mike Barlow: 08:59 A half a billion. Five hundred million. Five hundred and six million to be exact.
Jim Lazarus: 09:03 (Laughs). That's incredible. Thank you for that.
Jim Lazarus: 09:07 Tim, let's turn to you here for a second. At Dignity, you lead finance and revenue cycle for you're currently the fifth largest not for profit health system, very soon to be the first. Present in 48 states across the country. What are you all doing to reach across the aisle to the payer side and help create a better relationship?
Tim Panks: 09:23 Thanks, Jim. First, let me, let me explain our partnership with Optum360 and what we've done to prepare for this. So we see Optum360 as our revenue cycle team. They sit by us day-to-day in our hospitals, uh, they work with our patients and, and we've come together as, as a team. They do our end-to-end revenue cycle for all 39 of our hospitals. And, and what that really covers is from registrations until the account is closed. We have Optum360 doing that for us. And that, that equates to around 10 billion of our 12 billion dollars of patient, uh, revenue.
Tim Panks: 09:56 Second, in order to get prepared for working with, uh, the payers in a, in a more robust manner, we needed to make sure we had of our initial denial information accurate, uh, so we can be transparent as well. And so we, uh, implemented a number of technologies and, uh, some new process enhancements through Optum360 so that we have accurate data and we're ready to produce that and, and sit down with the payers.
Tim Panks: 10:20 Lastly, uh, we've ... because we're ready now, we've taken on three pilots with three different payers and we're looking at same thing that, that Mike was talking about. How do we reduce initial denials, save administrative costs on both sides and at the end make it more friendly for the patient. And so to do this we've got a triad that we've set up. It's Optum360, it's the payers and then it's Dignity Health's team and our physicians because they're a key part of this. We're still a little early in the process to, to rally around achievement and success rates yet, but we're headed in the right direction.
Jim Lazarus: 10:56 That's great. That's real interesting. Thank you for sharing.
Jim Lazarus: 10:58 So, Tom, we've just had, literally, a payer and a provider talk about how they're coming together and the work that they're doing to really reduce the denials, the friction in the system. I think this is a great chance for you to share kind of the vision you have as Optum360 CEO.
Tom Boehning: 11:12 Yeah, and drop the mic. Um, the statistics that were shared by Mike are shared by the providers, the hospitals and the payers. A 31% reduction in claim denials, that's the enablement of delivering technology in the middle, uh, for all the constituents. So and it's completely aligns with the long-term vision of Optum360 which is to create a denial free healthcare system. And, uh, in preparation for today's session I think myself and my, my colleagues and partners here believe that's doable in our professional lifetimes. But in the near term, our mission is to try to ensure that 100% of all claims receive some payment at first pass. And that's doable with the technology delivered but it can only be realized if we partner. If Tim and Mike and the payers and the providers agree to collaborate on the delivery of this content and it has to be done in workflow. We can't simply just say, "Hey, go to this portal and you can get access to it." I think that's been one of the challenges with the, uh, with the Medicare administrators.
Tom Boehning: 12:17 So what we're trying to do is deliver our content in workflows so we can deliver it in the form of a points solution, we can deliver it in the form of a managed service, or we can come in, in the case of Dignity Health, and provide it as a complete end-to-end revenue cycle solution. But none of it can realized unless the cooperation exists between the payer and the provider and the enabling technology and services can be provided from a vendor like Optum360.
Jim Lazarus: 12:42 Yeah. Tim, let me come back to you for a second because Tom just mentioned the results from an end-to-end relationship and you shared a little bit about the special relationship. As a matter of fact, Dignity was the seminal partner in Optum360. What are some of the results of this kind of creative, innovative way of going about this?
Tim Panks: 12:59 Hm. Well, first of all, um, as most everybody here probably knows, uh, Dignity Health and Optum Insight formed Optum360 about five years ago. And the results the first couple of years were, were very slow to mature and there was really two major reasons for that. One, we were putting in, uh, EHRs at each of our 39 hospitals and at the same time adding the [Vulton 00:13:21] technology. And that took some time to get through the complex IT issues that were under at that time.
Tim Panks: 13:27 Secondly, we asked Optum360 to look up at the revenue cycle and, and their leadership agreed and said we need to do this, we need to build this so that we can reduce the time. We can get in a situation where we'll be able to work with the payers.
Tim Panks: 13:41 And then, lastly, um, be able to make sure that all the information that you need, your CFOs need, and so forth is going to be effective and, and useful. And so that's, that's what we embarked upon. And the ... however, after those first two years we've seen some significant changes, some significant gains in all of numbers and you can see some of the stats on the screen right now. Um, what we were able to reduce, our days in AR by over 12%. And that was done through a 26% increase in cash collections, not denials. We computer assisted coding, uh, resulting in productivity improvements which allowed us to get a, a drop in our lag time to drop claims. We've also seen roughly a, around 50% of, um, collections from self-pay due to increased, um, eligibility and financial clearance, uh, activity and work around that. And then, lastly, the addition of CDI technology, uh, to our platform has allowed us to increase our communications with our physicians and ultimately increase our CDI due to better, or CMI, due to better documentation.
Jim Lazarus: 14:45 That's right. And something that's always interesting to me is that you're doing this without making a significant capital investment in technology.
Tim Panks: 14:51 Yeah, that's, that's exactly right. We are, um ... had we not been in the relationship with Optum360, some of that technology we would have spent capital on. Um, instead we were able to use that capital for our patient care areas and make sure that it's facing the patient and spending it where we really need it.
Jim Lazarus: 15:07 Putting capital at the face of the patient.
Tim Panks: 15:08 Right.
Jim Lazarus: 15:09 I love that. That's perfect. Mike, let me switch gears for a second. We've talked a lot about financial and kind of claim results and innovation but I think everybody here is also thinking about what's necessary in the clinical space. As you look out across the Medicare landscape, what are some of the innovations that you think are necessary or needed and, frankly, what are you looking to from Optum360 to deliver on that?
Mike Barlow: 15:28 Well, it's really, I hate to say it, it's basic but if you realize that we're talking about a transaction, if we can, if we can ... there's a lot of global things that you can do but from a payer, provider perspective it's about that transaction and making that transaction as transparent as possible on both sides. You know, in the '90s we focused on electronic claims. Now, with the data that we have and the structure of that data and the fact that providers are bringing that data forward ... I mean, Tim's initiative is relative to a CDI. So now, they're looking to build a record to support the claim, I'm now looking for that record to come across with the claim. So the full transparency starts to make this realtime transaction that Tom's envisioning perfectly available because the technology now is there to take these individual transactions, these patient encounters that come out as a claim, turn into a payment. And there's a stream of data that can flow across that that's not just a claim data but a clinical element so that I have full transparency into what's supporting the claim.
Mike Barlow: 16:32 If we can travel them together, then we open up a whole new scope of the transparency paradigm. It allows the rules to be very dynamic and embedded into the transaction. And we're looking to use Optum ODX and NLP and it's NLP engine to kind of transport that capture, routing and utilization of the data because for us it's a workflow. Claim comes in and I've got to do certain things to it by the rules. If all the data's there then all the electronic engines that we can bring to bear start to make that transaction automatic, so.
Jim Lazarus: 17:04 I like the, uh, the concept. I think many of us struggle with this idea of clinical data and clinical data connectivity as this huge, enormous industry problem.
Mike Barlow: 17:12 It's a trail.
Jim Lazarus: 17:13 It's one transaction.
Mike Barlow: 17:15 Yep.
Jim Lazarus: 17:15 And at a transaction level it actually is straight forward and it is simple.
Mike Barlow: 17:19 Yep.
Jim Lazarus: 17:20 So, Tom, that's one example that Mike's given us around kind of clinical connectivity and the role that Optum360 can play with that. Broaden my lens a little bit, like, make it bigger. What else can we do?
Tom Boehning: 17:29 Well, it's interesting and, and Mike's analogy was a good one. He actually introduced us into CMS Proper and CMS said to us, "We've got a real problem with oxygen orders." Okay, what's the challenge? They said, "Well, the referring physician will send a patient to a DME vendor, the DME vendor sends the claim. But, if there's no correlating documentation, in many cases we deny those claims." And we said, "Well, how can we solve that problem together?" And to use Mike's terminology, ODX is, um, Optum360, it's what we call our optum data exchange. We're one of the largest independent health information exchanges in the country. And so what we're going to be doing with the assistance of Palmetto and CMS is setting up a pilot whereby we're going to connect the referring physician with the DME vendors so when a DME order is sent in and the DME claim is sent to CMS, we're going to auto draw just the information necessary to get that DME claim paid, we're going to run that medical record information as largely a progress note through our natural language processing engine to distill down the information into what's necessary for the rules of CMS. And CMS has committed to us that during this pilot period if we can distill the information down to the key markers they are looking in that documentation, no denials.
Tom Boehning: 18:50 So, again, completely consistent with our vision and our mission. And in great cooperation with the payers and the Medicare administrators to solve the problem for the referring physician, the DME vendor, and the payer.
Jim Lazarus: 19:02 Almost sounds to good to be true. (Laughs). So let's switch for a second. Tim, um, patient. We talked it-
Tim Panks: 19:08 Yes.
Jim Lazarus: 19:09 ... I mentioned it in my opening monologue. I can't think there's an organization in the country that isn't kind of spending so much time right now thinking how do I meet the patients where they are and what does that mean for what I do, how I do it and where I do it, much of which has to be transformed? What are you all doing at Dignity Health and what role is Optum360 playing in, in addressing this patient financial burden that is suddenly upon all of us individually and our organizations?
Tim Panks: 19:32 Right. Well, first of all that's a, that's a big hill to climb, um, in what we're dealing with today but we agree with you completely. At Dignity Health our patients come first. I mean, hello, human kindness. You've all seen our marketing there and it's real for us, it's what we do. Um, we, the patients continue to see increases in their financial responsibility. I think you mentioned that in your, your opening comments. They're shopping for care more and more each day. Uh, registration processes take too long. Uh, patients have to provide their data numerous times during their care visit. Um, it's next to impossible to explain revenue cycle, uh, process and what's going to come out of that.
Tim Panks: 20:09 And because of all those complications and more, um, a lot of the things we've discussed today, we've heard today, um, Dignity Health is in process of going digital. Um, we know we need to be able to have more friendly access for our patients, be able to provide information to them where they live. And so, right now, uh, within Dignity Health on, mainly on the ambulatory site, our patients can schedule their visits, our patients can complete online registrations, they can make payments, uh, for the care they receive, and in the acute settings we produced, uh, way finding. Everybody who has been at a hospital, you know how hard it is to go from point A to point B. Well now, on an app you can ... all of our hospitals are way finded. And our digital team has done a wonderful job there.
Tim Panks: 20:52 Um, in this we've also started talking to Optum360 in saying help us produce this for acute site as well. We want to cover all of our patients. And so there, we've started that process and we look forward to, uh, continuing to build that out.
Jim Lazarus: 21:08 And I think you've shared something around how you actually see a role for the payers and some of the initiatives that you're doing there actually influence what's happening with the patients?
Tim Panks: 21:16 Yes. I think, um, anytime that the payer, the transparent record that we talked about. We get everybody involved in that, um, will get to the best care that we can. I think one of the speakers earlier was talking about that as well.
Jim Lazarus: 21:28 That's really interesting. So anybody who knows me as a rev cycle expert, I never pay a bill until I go to collections for some of the reasons that you all shared. Perhaps one day I actually can feel comfortable in making that payment-
Tim Panks: 21:38 That's right.
Jim Lazarus: 21:39 ... and not, uh, not having to wait until it all can go [inaudible 00:21:41].
Tim Panks: 21:40 That's right. And that's how we can reduce some administrative expense as well. Yes.
Jim Lazarus: 21:43 I love it. So, Tom, I think patient is really front and center in the vision you laid out, right? A denial free healthcare system really benefits not only trading partners but the patient ultimately and how we're able to provide that care and work with that. Can you give me another example of work that we've done in helping patients with their financial burden? I know that there's some examples in even the lab space, something I don't think most folks here wold have thought of as a kind of estimation hotbed.
Tom Boehning: 22:07 (Laughs). Exactly. Well, as it happens, Optum360, one of the largest lab vendors in the country is a customer of ours. And they came to us and said, "Look, we've got all this money that we're not collecting from patients because there's no, uh, estimation at point of patient presentment on what their responsibility is." And the numbers are enormous, hundreds of millions of dollars, nine dollars at a time. Because these are lab services, they don't have high patient responsibilities.
Tom Boehning: 22:35 So in partnerships with the payers, and I'll speak to that in a moment, as well as this particular client, uh, we were able to first get the order electronically sent from the provider to the lab. At that point when you present to get the blood draw, we do an eligibility verification through our clearing house. We're the second largest claim clearing house in the country. We then validate the integrity of the lab panel based on our claim editing solution. And then, in cooperation with the payers, we bounce it up against the contracted rate. So you have a 50 dollar serviced, 41 dollars of it is payable by the payer, nine dollars is the patient's responsibility. And it is presented right there to the phlebotomist, or whomever the front desk person is, before the blood's even drawn.
Tom Boehning: 23:20 And we're adding a new twist to it here in the, in the upcoming weeks. Many don't know but Optum Bank is the largest administrator of health savings accounts in the United States. We're doing a final eligibility verification after we've done all the preceding, to see if that patient is an Optum Bank customer. And, if it is, we're going to auto draw from the HSA that nine dollars. And then, the lab company from whom we're providing these services for, is made whole on the transaction as the patient is there, even prior to the service being rendered. And what, you know, we're working with Tim and we work with the payers is that type of a model transcends certainly labs. I mean, it's something we can provide in the ambulatory space, in the acute space, and really across the system. But it's the transparency in cooperation with the payers that makes that model plausible.
Jim Lazarus: 24:13 That's real interesting. So I no longer have the choice now to pay, it's going to be auto deducted. I love it. So let me ask, uh, from the panel, just closing thoughts, right? We've talked about innovation, we've talked about the patient perspective, the clinical perspective and certainly kind of claim and financial. Mike, let me turn it to you. What else are you thinking about as you think about innovation going forward and where we need to be?
Mike Barlow: 24:33 Well, the good news and bad news is that as a government contractor, I've got rules that are going to change tomorrow so I've got plenty of work to do. And I just want to contain to build those rules and I want to make them ... I might have used the word over and over again, the transparency from a payer perspective is key because if I'm transparent about what the rules and I can communicate with the provider community and educate them to comply, you know, to meet those rules, then my work is easy. And I really do have the vision, believe it or not, of claim comes in, payment goes out and all I have is machines that match up the data bits. And every now and then something might have to happen but it would be the rare occasion instead of the norm. I mean, I have entire processes built to handle the exceptions that are generated from today's situation.
Mike Barlow: 25:24 So I want to see us working on integrated system. Not just within in healthcare provider but in ... because it's a health information supply chain. It's an end-to-end process. Because if you're going to provide a service, somebody's got to be paying for the service, or you've got to account for the service. So let's make the whole process transparent. So just get those changes into the transaction and then we'll all be happy, happy campers.
Jim Lazarus: 25:51 So transparency one transaction at a time?
Mike Barlow: 25:53 That's it.
Jim Lazarus: 25:54 I love it. Tim, what do you think?
Tim Panks: 25:55 You know, um, I think Mike covered it very nicely. I think the, the statement that it takes a village, it's going to take all of us. It's going to take the payers, uh, certainly the providers, the hospitals, the physicians. Um, um, individuals or companies like Optum360 that, that can provide the technology for us to, to bring this together. Um, we're all going to have to be in this working very hard to do it. I think we've, we've got a little bit of a start now, starting to see some momentum and we need to continue that throughout time. And, and as Mike said, it's got to be transparent, we've got to have a true partnership across all, all areas for us to do this. So we're excited about it and, and we're fortunate. We've got Optum360 on our side working through the technology pieces for us.
Jim Lazarus: 26:42 That's right. So, Tom, maybe the, the last word to you. It sounds like there's innovation across the, uh, across the board. Payers and providers have literally almost sung Kumbaya up here this morning instead of to use your phrase, is it drop the mic, our work is done, let's go off and have a drink? Or wha-, what else can Optum360 be doing here? What's next?
Tom Boehning: 27:00 There's a lot we still have to do. Um, you know, there's, there's still the barriers that need to be broken down between payers and providers. Your opening statement I though were terrific. One can't vilify the other and, uh, expect us to get to the result that we all aspire for. But I do think it's interesting to hear both side talk they want to solve the same problem. And, uh, I think we're fortunate at Optum360 to have technologies that can be delivered in workflow that can help solve the problems. So for instances, uh, for those, uh, that use our, um, automated coding tools. We've seen a 40% to 50% improvement in time to code, additional 20% to 30% improvement in time to bill. Uh, for those that, uh, consume our physician advisory services, we've got alignment to about 94% of all cases where the payer is agreeing with our decision on those particular cases.
Tom Boehning: 27:57 And then, lastly, while we have a mission for 100% of claims to receive some payment, not full payment but some payment at first pass, when we do deploy our technologies and we do have cooperation between the partners, we're up to 94%. So we have a heck of a lot of work to do. That last 6% is definitely hard to get to. But when both parties say, "Hey, we want to work with 360 or other vendors to help realize your vision, your mission, because it aligns with our own, then we know we're on the right path." And it's exciting for us. We need to recruit more payers to participate. We need to use, um, our great health system customers to help us in that recruitment because they have a little leverage with those payers to bring them in and talk to them. We need to continue to advance our footprint with CMS. I mean, the statistics that Mike was sharing, 500 million in savings to the CMS system, that's two jurisdictions.
Mike Barlow: 28:52 That's actually from just one.
Tom Boehning: 28:54 That's just the one jurisdiction. I mean, you spread that across all of CMS and you're talking extraordinary numbers and that doesn't include the Medicaid system. So the value is there for both side. If we can get collective recognition and appreciation for it and get alignment on the deployment of it, we can realize that, that vision of a denial free healthcare system.
Jim Lazarus: 29:17 Perfect. I love it. All right, I think that's the perfect place to stop for our session today. Uh, first I want to thank our panelists, Tom Boehning, Tim Panks, and Mike Barlow for their time. And also thank the audience for your time today. Thank you.
Through our Optum360 partnership, we implemented several solutions to improve payer relationships, specifically around claims transparency.– Tim Panks, Senior VP of Finance and Revenue Cycle Management, Dignity Health