Enhance claims payment accuracy
Everyone involved in health care delivery wants accurate billing and payment. Our team partners with providers, payers and other stakeholders to improve accuracy and transparency.
Our payment integrity solutions can be implemented at any stage. And they integrate with your existing processes.
Comprehensive payment integrity
Taking a comprehensive approach to payment integrity can help health plans reduce administrative and medical costs and improve relationships.
Explore our solutions
Advisory Services
Take the proactive path to payment integrity.
Claims Edit System
Edit claims for all business lines and claim types.
Claims Pricing Solutions
Drive prospective payment system pricing accuracy and efficiency with Optum® EASYGroup™.
Claims Validation
Validate all claims while minimizing provider abrasion.
Coding Advisor
Identify common billing errors and improve provider billing behavior.
Comprehensive Payment Integrity
Centralize payment integrity for increased results.
Coordination of Benefits
Identify critical administrative coordination of benefits issues.
Credit Balance
Maximize overpayment recovery.
Data Mining
Identify and recover payment errors.
Emergency Department Claim Analyzers
Control rising emergency outpatient facility cost.
Itemized Bill Review
Save on high-dollar inpatient cases.
Network Solutions
Our solutions focus on out-of-network claims.
Payment Recovery
Focus on claims resolution.
Subrogation
Maximize recoveries with member sensitivity.
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Achieve claim pricing accuracy and efficiency
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Everest Group recognizes Optum as a Leader
Optum is named a Leader in five 2020 PEAK Matrix reports.
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