Improve payment accuracy without amplifying abrasion
As medical claim costs continue to grow, health plans are challenged to deliver cost savings without amplifying member and provider abrasion. We offer a suite of fully integrated, end-to-end solutions that help health plans effectively and efficiently manage medical expense. Available both pre- and post-payment, Optum® Payment Integrity solutions improve payment accuracy at every point in the claim lifecycle while reducing the administrative burden on providers.
Explore our solutions
Coding Advisor
Identify common billing errors and improve provider billing behavior with our pre-submission, outreach-based provider engagement solution.
Claim Pricing
Improve prospective payment system pricing accuracy and efficiency.
Claim Editing
Achieve clean claims and maximize medical spend savings with flexible, real-time claim editing software.
Claim Review
Identify and prevent improper payments and reduce medical spend with a comprehensive suite of pre- and post-payment solutions.
Coordination of Benefits
Identify and validate primary policy coverage both pre- and post-payment.
Subrogation
Identify, investigate, recover and prevent inaccurate payments linked to accident-related medical and disability expenses.
Credit Balance
Research and resolve unsolicited and solicited overpaid claims.
Optimize your payment integrity program
Optimize your payment integrity program with our Comprehensive Payment Integrity Assessment. Our team of experts will analyze your current program to identify gaps and opportunities for improvement, providing you with a strategic roadmap to modernize your payment integrity office and increase medical spend savings.