Revenue Cycle Management
OptumInsight revenue cycle management solutions and consulting services leverage innovative technologies and expertise to provide hospitals and health systems with unprecedented control over their coding, compliance, and reimbursement processes.
We’ll help you capture more accurate patient billing data, refine eligibility verification, and make essential financial information accessible across your entire care community, including IDNs, hospitals, academic medical centers, and contracted physicians.
Bridge the gaps in your revenue cycle and build a firmer foundation for excellent care. Call us today.
Billing Management
Billing management provides direct access to Medicare’s online system, confirming claim accuracy prior to actual submission. For both government and commercial payers, it applies the required edits, tracks adjudication status, and automatically generates secondary claims when appropriate.
Benefits:
- Improve first-time acceptance rate
- Automate claim submission and status inquiries to increase productivity
- Accelerate secondary claim submission
- Perform pre- and post-submission compliance checking
- Improve productivity and strengthen decision support
Coding and Reimbursement
OptumInsight offers an array of coding and reimbursement solutions that help you remain compliant and maintain an efficient path to fair and timely reimbursement.
- Significantly improve coding accuracy and compliance
- Simplify regulatory content management
- Transition smoothly to required clinical documentation changes
- Prepare for a successful transition to the new ICD-10 code sets and HIPAA 5010 mandates
- Keep up with ever-changing prospective payment systems (PPS) rules
Patient Access Management
Patient access management helps you get it right the first time, from pre-registration through eligibility verification, financial clearance, and financial counseling.
Our integrated functions help you eliminate registration errors, streamline patient access processes, and determine self-pay responsibility so you can minimize denied claims and drive effective up-front collection efforts. As important, patient access management enables you to directly tie your front-end work to the back-end results.
Payment Management
Payment management works with your in-house scanning solution or bank’s lockbox to automate payment processes and enable comprehensive, efficient management.
Benefits:
- Streamline payment processes
- Consolidate and standardize information from multiple formats
- Automate data flow, batch verification, and posting
- Increase efficiency and improve reporting
- Eliminate labor-intensive, error-prone manual processes
Resolution Management
Our resolution management services help you improve denial capture, recovery processes, and cash collections, while providing meaningful and actionable denial data from all sources.
Benefits:
- Gather data from disparate systems to create patient-centric financial records
- Automate and standardize denial capture for all payers
- Increase cash collections
- Reduce denials by identifying root cause early in the process
Revenue Cycle Services
At OptumInsight, we focus our revenue cycle services on the areas that have significant impact on your financial position — including denial recovery and prevention, accounts receivable services, and comprehensive secondary claims management. We go beyond best practices to design the best solution for you.