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an expansive network and the right tools drive lower costs

Optum offers medical services including a network of hospitals, physicians, clinics and specialists who are credentialed and vetted to ensure quality care for your claimants. Our exclusive connection with UnitedHealth Group's OneNet® network helps increase in-network transactions, drive data integrity and simplify claim administration, resulting in greater savings. Working in conjunction, our bill review service increases medical savings by streamlining workflows and improving efficiency.

NETWORK STRATEGIES DRIVE THE LOWEST COSTS FOR you

  • Expansive network drives maximum discounts
  • Network enforcement tools capture out-of-network transactions and convert them in‑network
  • Bill review services provide a best-in-class solution for medical bill processing and reduce out‑of‑network transactions to the lowest cost

BILL REVIEW

Medical bill review supplements network strategies to increase savings even more. Our knowledgeable and experienced in-house professionals leverage data and automated processes to complete timely, accurate, professional-level clinical reviews. As a result, you will realize maximum savings as the process:

  • Combines national coverage capabilities with regional networks
  • Applies national coding parameters
  • Detects improper billing practices and duplicate entries
  • Integrates all utilization review decisions into the medical
    bill review process

Like many of our programs, medical bill review services can be integrated with other products, such as PPO and speciality networks or provided on a stand-alone basis.

Case Management

Starting with the first report of injury, our case management program establishes a claimant advocate who coordinates and channels care, where permitted, with accessible and experienced network providers. This helps to make certain medical treatment is:

  • Managed proactively based on recognized medical guidelines and evidence-based medicine
  • Safe, cost-effective and designed to promote recovery
  • In accordance with program parameters and jurisdictional regulations
  • Compassionate and well-coordinated to alleviate concerns and promote adherence

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For more info email
ExpectMore@optum.com