About This Webinar
When it comes to traditional claim processing, there are many inefficiencies that cause high administrative costs and tremendous clinical and administrative waste for the health care system, including:
- Lack of interoperability between health plan systems and provider workflows
- Manual processes to exchange data
- Lack of visibility into health plan-specific requirements
- Variability in health plan requirements
What is the result? Preventable claim denials that create rework and unnecessary administrative costs for both health plans and providers.
Join this session to learn how payers and providers can shift from traditional denials-based claim accuracy processes to error and denial prevention with Optum® Comprehensive Denial Prevention. Comprehensive Denial Prevention creates a connection between the health plan claim editor and the provider practice management system, enabling billing entries or claims to be evaluated against health plan-specific editing rules prior to adjudication. Providers are alerted to actionable claim errors or gaps in information in near real-time and can take corrective action within their existing workflow, resulting in more accurate, complete claim submission the first time.
Attendees Will Learn How To
- Utilize their editing rule sets to evaluate coding and billing prior to adjudication
- Efficiently notify providers of coding and billing errors within their existing workflows to reduce denials
- Educate and engage providers in denial prevention programs
