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Durable Medical Equipment Benefit Management

Manage all DME spend with an integrated solution that helps health plans reduce costs while improving the member, DME supplier and ordering provider experience.

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Enabling better DME benefit management

As the population ages and care moves to the home, the DME market is rapidly growing. The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060. Currently, the process of ordering and managing DME is complex and disjointed. This leads to challenges for providers, patients and health plans.

To address this, Optum is collaborating with CareCentrix, a leader in health care at home, to offer a turnkey DME Benefit Management solution and point-of-care platform for health plans.

The result is reduced costs and administrative savings. At the same time, we’re providing greater ease and transparency in process ordering and managing DME.

Solution insights

Optum and CareCentrix help health plans ensure appropriate usage and timely fulfillment. We provide the industry’s most comprehensive DME benefit management solution.

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Improved patient outcomes and satisfaction

Enhanced member experience, greater pricing transparency and on-time delivery leads to patients receiving their DME faster. They get the support and education to ensure appropriate use.

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Ease of implementation and DME fulfillment

Existing Optum customers enjoy ease of implementation with near-zero IT lift. New customers have minimal lift. All experience incremental administrative savings.

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Increased cost savings

Proven cost savings for health plans with guaranteed savings of up to 15% on DME spend through member support and network optimization.

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Improved ordering provider experience

Automated service validation and a seamless omnichannel experience deliver best-in-class ordering provider and member experiences.

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Fewer friction points across the DME workflow

The solution provides better:

  • Transparency to deliver optimized price points
  • Optimization with coverage determination and prior authorization requirements
  • Spend management through lower prices and claims management utilization to ensure accurate claims, which reduces overpayments
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Helping health plans reduce spend

With an end-to-end, streamlined approach, we help you reduce the total cost of care by generating medex savings. This is achieved through preferred DME supplier networks and utilization management. We also address existing workflow problems through order digitization and closed-loop feedback within a single point-of-care platform.

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Manage DME with ease of ordering and greater transparency

We bring you the most comprehensive, next-generation DME benefit management solution. With direct integration into more than 2000 supplier workflows and clinical provider EHRs, our solution helps ensure appropriate utilization and timely fulfillment. The solution provides a more frictionless workflow and improves the ordering provider and member experience.

Realize cost savings with improved provider and member experience.

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