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OPTUM

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MOVING TOWARD BETTER FINANCIAL HEALTH

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Advance the revenue cycle for greater financial agility.

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REVENUE CYCLE TRANSFORMATION

 

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UTILIZATION REVIEW


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CODING AND DOCUMENTATION

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CLAIMS 

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REIMBURSEMENT

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ENDING ADMINISTRATIVE WASTE IN HEALTH CARE

See how our financial ecosystem connects all parties.

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- [Narrator] The US healthcare system suffers from 200 billion dollars of
administrative waste annually, with inefficiency between payers and providers at
the root and consumers caught in the middle. Optum360 is creating a financial
ecosystem that's connected, fostering collaboration between payers and
providers, while improving the consumer financial experience. We consolidate
data from disparatete EMR systems, harmonizing it for a better documented claim,
and use our clinically aware natural language processing to find data that
supports the revenue cycle decision making process. Here, Mary arrives at the ER
with breathing trouble. She's admitted with a history of COPD. Her work-up
creates dozens of documents from different clinicians, while artificial
intelligence finds data in her record to support a hospital admission. Within
seconds, key markers from Mary's medical history, physical exam, and chest x-ray
trigger the documentation needed for reimbursement. The claim is paid.
Administrative costs are saved, and Mary is spared financial stress. In this
modern exchange, hospitals realize a 94% payer acceptance rate for in-patient
recommendations. Many clients see a 20 to 30% improvement in time to bill, and
CMS Medicare Administrators report 31% fewer suspended or denied claims. With
Optum360 cash flow accelerates, denials decline, waste diminishes. And most
importantly, people like Mary have a better financial experience.

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PHYSICIAN ADVISOR EFFECTIVENESS

Physician advisor effectiveness can affect your facility's financial integrity.
Learn how to maximize their impact.

Learn more


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REVENUE CYCLE SMART SOURCING

Rethinking outsourcing to deliver strategic innovation.

Learn more



> A transformation like this doesn’t happen overnight. So far, we've increased
> our EBITDA by millions with improved processes and efficiency.
> 
> – Daniel Morissette, Sr. Executive Vice President/CFO, Dignity Health See
> success story

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FEATURED ARTICLES

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EVEREST GROUP PEAK MATRIX LEADER

Optum is named a Leader in five 2020 PEAK Matrix reports.


Learn more

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PHYSICIAN ADVISOR EFFECTIVENESS

Explore the four elements of a successful physician advisor program.


Learn more

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See how our connected approach helps you keep your patients and your business
healthy.


Request more information

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