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Claims Pricing Solutions

Drive prospective payment system pricing accuracy and efficiency with Optum® EASYGroup™.

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Accurate claims pricing through automation

EASYGroup automates the process of accurate claims editing, grouping and pricing across multiple care settings, enhancing auto-adjudication rates and provider relationships.

Maintain rules, content and ongoing regulations

EASYGroup™, our portable software library for managing prospective payment system agreements, can help health plans maximize savings by accurately paying out-of-network Medicare claims and standardizing contract management practices for hospitals and physicians.

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Create greater pricing transparency

Our web-based claims processing platform, Payment System Interface (PSI), goes beyond individual claim reviews and batch claims processing to enable advanced modeling, analytics and reporting. PSI also helps health plans across all lines of business create greater pricing transparency and reduce provider abrasion.

Application Managed Services

Enhance your prospective payment system with a dedicated Application Managed Services team that will help maximize results through ongoing support of your entire PPS process — from installation to validation and maintenance, regulatory insights and ongoing support.

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Claims pricing in the cloud

Gain efficiencies in time and resources by moving claims pricing to the cloud. EASYGroup and Payment System Interface are now available via a cloud-based delivery model, allowing you to increase your speed-to-production while decreasing reliance on IT resources.

Add Claims Pricing Solutions to your payment integrity portfolio today.

Featured insights

Achieve Accuracy and Efficiency in Claim Pricing

Create a framework that drives first-pass adjudication.

Trends and perspectives for health plans

Driving toward the same things for our health care system — better quality, lower cost, and higher consumer and provider satisfaction.