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Revenue Integrity

Renee sees RCM through a new, modernized lens

“Providers are asking us how to evolve with this new, more complex system. How do they meet challenging payer policies, reduced funding and the rising complexity of value-based care?”

Renee Monahan 
Senior Director, Optum Advisory Services

Read Renee's reply

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Revenue integrity: Bridge the gaps

The modern image of a mature revenue integrity program includes all the traditional areas and some new ones. As the revenue cycle expands, so do the complexities. The focus must shift from piecemeal methods to a holistic approach that bridges the gaps between clinical operations, coding, CDI and the business office.

Explore these resources that can help you solve and prevent problems that lead to revenue loss.

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Learn what your peers are doing

  

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Regional One transforms case management

Read how utilization review improvements helped overcome staffing pressure.

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Upfront editing drives consistency

Health system achieves great returns with Optum® Claims Manager.


Read success story

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Improve efficiency with Optum CAC and CDI 3D

See how a health system reached a 99% physician response rate.

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Lima Memorial solves for disjointed CDI process

Coding efficiencies helped improve seven key metrics with advanced technology.

Achieve revenue integrity

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White paper

Revenue cycle innovation: You don’t have to go it alone

Find a strategic partner to ensure financial resiliency.

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White paper

Defending emergency department reimbursement

Learn how to strengthen your ED visit-level determinations.

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Article

Two most astute revenue cycle investments

Strengthen revenue performance with two astute investments.

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White paper

The secret to untangling medical necessity denials

Review factors hidden by your denial rate.

Optimize revenue recovery

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Article

Five things your denial rate isn’t telling you

How to dig deeper to uncover areas for improvement.

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White paper

Front-door digital strategies to improve patient perceptions

Discover how a digital patient engagement strategy can provide easier access, reduce cancellations, and enhance front-end collections.

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Success story

A/R Recovery Service provides revenue continuity

Provider maintains A/R continuity during HIS conversion.

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Success story

Physician group achieves record performance

Optum Ambulatory Services team leads system transition.

Succeed in value- and quality- based contracts

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White paper

Giving patients a clear look at their care

A better patient experience through price transparency.

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White paper

AI advances the revenue cycle

The use of NLP makes the revenue cycle work smarter, not harder.

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White paper

Innovating a new model of utilization review

Learn five ways to use new processes and technology to improve UR.

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Article

Clinical intelligence

A smart revenue cycle investment in trying times

Our technology and services can help boost your organization’s financial health. Learn how.

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Utilization review (UR)

Reduce denial rates, improve reimbursement and minimize audit risk.

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Coding and documentation

Get smarter medical records using proven tools and services.

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Claims

Streamline your claims process from preparation and submission to payer response.

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Reimbursement solutions

Reduce write-offs and increase recovery rates.