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Healthcare operations

Cost Avoidance

Identify common healthcare billing errors and help prevent claim denials in real time.

Proactively fix coding and billing errors before claim submission

By leveraging AI and pre-claim submission edits, our solutions can help prevent improper health payments more effectively. We give providers the actionable insights they need to submit claims accurately and at scale.

Help reduce provider abrasion by enabling claim accuracy

Shift your edits left by taking a proactive approach to correcting billing errors before claims are submitted.

Service

Coding Advisor

Best for:
  • Payers

Education solution to help providers reduce common billing errors.

Software

Real Edit Intelligence

Best for:
  • Payers

Help prevent claim denials by shifting your edits pre-adjudication or submission.

Healthcare payment integrity trends

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Article

Beyond payment integrity: An AI-driven approach to affordability

Medical costs are rising, and health plans need solutions. See how an AI-driven, enterprise-wide approach may be the key to affordability.

Article

Improving transparency in payer-provider connections

Explore how real-time connections can enable more accurate claim submission to create a more efficient healthcare payment system.

Article

Trends shaping the future of payment integrity

Explore the market trends that are shaping the future of payment integrity and learn what they will mean for health plans.

Improve claim accuracy and reduce provider abrasion with Optum