Let Optum™ help you increase efficiency by paying it right the first time.
Avoid Errors, Contain Costs
Optum pre-payment solutions improve the integrity of the payment process and effectively contain costs by identifying erroneous and inappropriate claims before payment is made. That way, you prevent rather than recover inappropriate payments. It’s a more efficient approach, particularly when coupled with traditional post-payment and recovery activities. Our pre-payment solutions can help you:
- Apply advanced predictive analytics services to identify risk and anomalies with no disruption to the payment cycle
- Identify errors and inaccuracies before the claim is paid, allowing upfront correction by providers
- Automatically review and edit claims submitted by providers and facilities
- Ensure accident claims are paid by the appropriate parties
- Reduce or eliminate overbilling and overpayment
- Identify fraud and potential fraud networks
Optum Electronic Visit Verification
The Optum™ Electronic Visit Verification solution is a reliable and cost-effective solution that helps more efficiently deliver care by improving payment accuracy, program integrity and overall patient care. Using global positioning system (GPS) technology, Electronic Visit Verification provides a platform for measuring, recording and verifying home health caregivers and transportation services in real time.
Prepayment Review Solution
Prevent fraud before it happens
Optum Pre-payment Review solution uses advanced predictive analytics services to measure improper payment risk and identify anomalies in providers’ claims. It uncovers inaccuracies before claims are paid, with no disruption to the payment cycle. Optum pre-payment predictive analytics saved health plans more than $120 million in 2012, while also helping to correct payment system vulnerabilities and providing support for law enforcement.