A MULTI-DISCIPLINARY APPROACH TO SETTLEMENT COMPLIANCE
Our Settlement Solutions have been called best-in-class, and for good reason. As an industry leader in pharmacy benefit management, we provide advantages that are unique in the Medicare
Set-Aside (MSA) industry. Our technology identifies high-risk claims and applies intervention tools to control costs, improve therapeutic results and provide guidance for clinical decision-making. We have the pharmacological perspective and technological solutions to consistently:
- Contain clinical costs while providing needed medications
- Provide fast and compliant settlement solutions
- Accurately forecast future medical costs
- Achieve a high acceptance rate for Section 111 claim reporting
Our solution enables accurate and cost-effective allocations in accordance with Medicare Secondary Payer compliance, while mitigating potential barriers to settlement. You’ll find our compliance strategies to be flexible, adaptable and backed by collaborative, service-focused partnerships. This is the optimal way to meet the needs of the injured person while providing you with a financially-sound settlement solution.
Accurate forecast future medical costs through predictive analytics
Achieve a high acceptance rate for Section 111
Provide fast and compliant
Leading-edge technology drives a high acceptance rate
Our industry-leading Mandatory Insurer Reporting (MIR) solution, MedicareConnectSM, meets the requirements of MMSEA Section 111 for NGHP claims and has an adjusted acceptance rate approaching 100%.
The platform uses historical and ongoing knowledge of governmental and state reporting nuances and requirements to achieve compliance. It provides customized IT connectivity for both large and small entities, can be implemented with minimal resources, and includes tools and advanced reporting capabilities to minimize risk.
Optum settlements are managed quickly, cost-effectively and in compliance with government regulations.