Compliance and Audit Management
Compliance challenges for health care facilities are compounded by constantly changing regulations. We can help you prepare your staff and internal systems for change so that you don’t miss out on reimbursement.
Our solutions can help your facility:
- Address the impact that MS-DRGs have on coding and billing
- Save valuable time and resources in the CMS RAC audits and appeals process
- Achieve ICD-10 compliance
- Streamline the revenue cycle
- Reduce claims denials
- Optimize cash flow
Coding Billing and Reimbursement
OptumInsight offers an array of coding, billing, and reimbursement solutions that help you remain compliant and maintain an efficient path to fair and timely reimbursement.
DRG Compliance
The Centers for Medicare & Medicaid Services is proposing enormous changes to its inpatient services payment system — most notably clearer definitions of a patient’s condition severity via Medicare Severity DRGs (MS-DRGs).
We can help you prepare your staff and internal systems for the change so that you don’t miss out on reimbursement.
With OptumInsight, you can avoid disruptions to revenue cycle management:
- Identify financial and coding impact
- Safeguard cash flow
- Protect operational efficiency
RAC Compliance
The OptumInsight RAC Support Program has all the products, services, and expertise you need to save valuable time and resources in the audits and appeals process.
Benefits:
- Minimize the cost of preparing, submitting, and following up with appeals
- Educate stakeholders
- Identify and address areas of exposure
- Assist with process improvement and appeals to minimize the effects of RAC