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Find out about our temporary funding assistance program for those affected by payment services disruptions.

Case study

Case study 2: High-dollar claim savings

DRG outlier identified, resulting in $600,000 savings.

Itemized Bill Review case study thumbnail

Diagnosis-related group (DRG) outlier

For a Blues plan, Optum clinical staff found dosages for the identified medication far exceeding the recommended maintenance dose for a neonate. This saved our client nearly $600,000, more than one-fourth of the billed charges.

Itemized Bill Review

Our targeted clinical and financial review leverages Centers for Medicare and Medicaid Services (CMS) and clean-claim evaluation to review inpatient facility claims.​ We work in concert with our clients’ provider relations team, which minimizes provider abrasion.

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Related resources

Case study 1: High-dollar claim savings

DRG outlier identified, resulting in $200,578 savings.

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.

Comprehensive payment integrity savings

Inform and improve your entire claims management lifecycle.

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