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Claims and payment accuracy

Optum® Payment Integrity strengthens accuracy at every touch point in the billing lifecycle.

Enhance claims payment accuracy

Everyone involved in health care delivery wants accurate billing and payment. Our team partners with providers, payers and other stakeholders to improve accuracy and transparency.

Our payment integrity solutions can be implemented at any stage. And they integrate with your existing processes.

Explore our solutions

Claims Edit System

Edit claims for all business lines and claim types.

Claims Pricing Solutions

Drive prospective payment system pricing accuracy and efficiency with Optum® EASYGroup™.

Claims Validation

Validate all claims while minimizing provider abrasion.

Coding Advisor

Identify common billing errors and improve provider billing behavior.

Comprehensive Payment Integrity

Centralize payment integrity for increased results.

Coordination of Benefits

Identify critical administrative coordination of benefits issues.

Credit Balance

Maximize overpayment recovery.

Data Mining

Identify and recover payment errors.

Emergency Department Claim Analyzer

Control rising emergency outpatient facility cost.

Network Solutions

Our solutions focus on out-of-network claims.

Itemized Bill Review

Save on high-dollar inpatient cases.

Subrogation

Maximize recoveries with member sensitivity.

Comprehensive Denial Prevention

Prevent claim denials and reduce administrative waste.

Realize cost savings with our payment integrity solutions

Related content

Achieve claim pricing accuracy and efficiency

Create a framework that drives first-pass adjudication.

Activate savings with comprehensive payment integrity

Taking a comprehensive approach to payment integrity can help health plans reduce administrative and medical costs.