Comprehensive Denial Prevention

Did you know 86% of claim denials are preventable and result in needless rework and administrative cost for health plans and providers?*

Optum® Comprehensive Denial Prevention is a shift-left provider education and error prevention program that will change how you think about payment accuracy and denial management. Our tools help both health plans and providers by:

• Preventing claim denials
  
• Enabling mutual transparency
• Providing greater efficiency
• Reducing administrative burden
• Increasing payment accuracy
• Improving the patient experience 

With Comprehensive Denial Prevention, health plans and providers exchange common information at the point of coding and billing.

We do this by creating connections between health plan claim editors and provider practice management systems. This enables billing entries or claims to be evaluated against editing rule sets before submission or adjudication.

With our tools, providers are alerted to actionable errors in near-real time. This allows them to take corrective action within their existing workflows and submit accurate, complete claims the first time.

Educating providers is critical to improving claim accuracy. Our managed services team directly engages providers to help improve:

• Messaging adoption
  
• Claim correction rates
• Provider satisfaction