Payment integrity: Discover new opportunities for savings
Optum provides a new comprehensive approach to payment integrity that moves beyond current post-payment recovery efforts. Uncover new opportunities for medical and administrative savings.
Payment integrity (PI) is vital to the success of a health plan. Successful payers understand the importance of having a mature PI strategy. But they may not understand how to get there.
Optum is a leader in PI innovation. For 15 years, we've helped state Medicare and Medicaid programs and commercial plans adopt comprehensive strategies. Our PI clients routinely experience a 1% to 3% increase in medical expense savings.
Our solutions deliver affordable coverage without squeezing the quality of health care. We provide transparency and build trust with our partners. This gives health plans the confidence and the capacity they need to maximize payment integrity savings over time.
Explore the resources below for the latest research and insights into payment integrity — and how Optum can help.
Improving payment integrity performance
When it comes to payment integrity, payers can no longer accept the status quo. To stay competitive, they must find new savings opportunities at every turn. A mature PI strategy enables payers to uncover radical medical expense savings opportunities.
"A comprehensive model can help health plans save 8–10% or more of their total medical expense annually through payment integrity functions."
Steve Yurjevich, Senior Vice President and General Manager, Payment Integrity, Optum
Everest Group PEAK Matrix™ Assessment
Optum named Healthcare Payer Payment Integrity Solution Leader
“Optum’s extensive pre-submission, pre-payment, and post-payment integrity solutions portfolio complemented with Equain’s solutions has made it a partner of choice for healthcare firms. Additionally, their healthcare lineage coupled with the ability to operate as a strategic partner for clients has strong advantages.” Abhishek Singh, Vice President, Everest Group
PAYMENT INTEGRITY RESOURCES