Subrogation

Secure reimbursement

Optum™ Subrogation Services can successfully identify, investigate and recover accident-related medical and disability claims expenses for your organization.

Sometimes it’s necessary to intensify recovery efforts. You can be confident that claims will be paid when you use the subrogation tools and services at Optum™. Our experts empower health plans to:

  • Identify potential cases
  • Expedite case resolution
  • Recover accident-related medical and disability expenses
  • Track and report progress and performance

Recovery services

Optum investigates and evaluates accident details, contract language, law, insurance coverage, and other theories of liability to assess the probability of successful recovery. As appropriate, Optum subrogation professionals litigate to secure reimbursement on your behalf.


Identification Only™

Identification Only (ID Only™) Service augments your existing internal programs by enhancing identification and investigation of subrogation cases to determine the liable party.

Applying proprietary techniques called SubroAnalytics™, Optum mines claims data and identifies accident-related injury cases for review. Our algorithms leverage databases that contain information on more than 50 million individuals and 20 terabytes of statistically relevant data elements.

SubroAnalytics™ uses predictive analytics to:

  • Identify increased subrogation and savings opportunities
  • Identify hard-to-find cases
  • Identify high-recovery probability claim types
  • Expedite resolution through effective communication with members
  • Improve settlement ratios
  • Optimize recovery efforts to maximize recoveries
  • Provide data that will enable the business to make better decisions


Detailed progress and performance reporting:

  • Daily guidance provided on a claim-by-claim basis
  • Monthly performance reports on active cases
  • Negotiation progress
  • Projected and actual recovery results