Reduce low-dollar, high-volume errors
Low-dollar, high-volume billing errors are frustrating for providers and health plans alike. These kinds of errors often lead to provider abrasion due to increased:
- Claim denials
- Medical record requests
- Appeals
Optum® Coding Advisor is an outreach-based solution that uses paid claim data to identify common billing errors and educate providers to improve billing behavior on future claim submissions.
Drive long-term behavioral change
Our proven educational system addresses losses to more than 32,000 commonly up-coded low-dollar, high-volume CPT® codes, driving positive behavioral change and more accurate billing practices that result in:
- $3–8 PMPY (per member, per year) estimated savings
- Over 80% of engaged providers demonstrate positive behavioral change
- 9.6% decrease in the cost of outlier claims, on average
- 24% reduction in total overbilling, on average
