Hospital Solutions

A holistic approach to financial improvement

Hospitals are reeling from financial and compliance pressures. A combination of bad debt, newly covered patients, changing reimbursement models, and the risk of denials in the face of the migration to ICD-10 place already slim operating margins in greater peril. It’s easy to see why more than 70% of hospitals are reporting a loss in revenue.

 

“We needed to improve efficiency, productivity, accountability, and transparency. We had improved to the point where we couldn’t improve any more due to our manual processes.”

– Mike Wilson, Director of Business Services DCH Health System

 

Hospital IT and Information Systems

Enhance processes from patient registration to payment

By automating some of the more complex, detail-focused processes in the revenue cycle, our revenue cycle technology solutions help accelerate administrative workflows, improve accuracy and free internal staff to focus on other priorities. Optum360™ has unique proprietary technologies that provide an enterprise backbone upon which enterprises can enhance staff productivity and achieve demonstrable return on investment.

Hospital Managed Services

Outsourcing and advisory services enable internal staff to focus on business priorities

With expertise across the revenue cycle, we can manage any stage along the way. From coding to accounts receivable, our experts can take on your most labor-intensive administrative processes, enabling you to commit your staff where they’re needed most.

Medical Coding and Documentation

Optum360 coding resources have helped hospitals maintain efficient, reliable coding operations over 25 years of code changes, financial pressures and regulatory shifts. And now, with skilled services and breakthrough technology that cuts through the complexity of coding and clinical documentation improvement, Optum can help your staff be more productive — and proactive — in driving financial results across your organization.

Patient Access Management

Improve patient access

Efficient OptumTM patient access solutions help you get it right the first time — by eliminating registration errors, streamlining patient access processes and determining self-pay responsibility. Our integrated functions help you minimize denied claims and drive effective up-front collection efforts while enabling you to directly tie your front-end work to the back-end results.

Claims and Reimbursement

Handle your claims and reimbursements proficiently

Our proven range of claims and reimbursement solutions help you optimize every aspect of your revenue cycle. From accelerating reimbursement to reducing costs and errors, Optum™ solutions help you balance clinical and financial issues, remain compliant and maintain an efficient path to fair and timely reimbursement:

Denial Management and Recovery

Handle resolutions more efficiently

State-of-the-art Optum™ denial management and recovery solutions help you improve denial capture, recovery processes and cash collections while providing meaningful and actionable denial data from all sources.

Financial Compliance and Audit Management

Stay financially on track with federal and payer-specific requirements

Optum360 can help your hospital achieve the transparency, visibility and consistency needed to comply with federal and payer-specific requirements and, when necessary, manage the audit process. Through technology solutions and outsourced services, we can help you strengthen claims integrity to avoid disruptions to your revenue cycle.

ICD-10 Readiness

Enhance processes from patient registration to payment

By automating some of the more complex, detail-focused processes in the revenue cycle, our revenue cycle technology solutions help accelerate administrative workflows, improve accuracy and free internal staff to focus on other priorities. Optum360™ has unique proprietary technologies that provide an enterprise backbone upon which enterprises can enhance staff productivity and achieve demonstrable return on investment.