Detect, recover and prevent claim overpayments
Health care claim payments are complex, leaving ample room for inaccurate payments to slip through. Health plans can implement Optum® Data Mining, both pre- and post-pay, to help improve payment accuracy, reduce overpayments and save on medical and administrative costs without requesting provider documentation.
Our robust Data Mining solution can:
- Facilitate compliance with provider contracts
- Identify and resolve outlier billing errors
- Conduct reviews on adjudication and coding errors
- Prevent future errors and overpayments
Drive more value from your data mining solution
We bring unmatched data mining expertise and experience to help health plans achieve payment accuracy and reduce medical and administrative costs. Our results:
- More than one million claims reviewed daily
- More than $8 billion in annual pre- and post-pay savings
- 9 million industry rules, regulations and policies
- Over 1,200 algorithms to generate insights and drive greater accuracy