Optum™ Consulting Services
As a data-driven consulting organization focused exclusively on health and human services, our capabilities
are unmatched in the industry. Our services help clients increase revenue, manage costs, accelerate cash
flow, enhance clinical quality, and make more efficient use of capital and technology. We help organizations
optimize clinical, operational, and financial business performance. As a global provider of health care
consulting services, Optum offers tremendous breadth and depth of services to help clients drive powerful
business improvements that create meaningful, measurable results.
HIM Consulting—Optum consulting services use proven, benchmark-driven analytics to help hospital HIM
departments improve documentation and coding practices, optimize revenue, and reduce unnecessary risk.
Our senior consultants provide insight to help hospitals increase compliance, validate current reimbursement,
increase security, and improve confidence in HIM operations. In addition, we provide independent analysis of
current coding and documentation practices, as well as assessments of changes in coding process.
ICD- 10 Implementation and Education Services—We provide end-to-end ICD- 10 transition services—
from strategic guidance, readiness assessment, education, data conversion, and implementation to post-compliance monitoring, financial impact reports, and improvement activities—for providers and payers. Our
consultants can help drive strategic initiatives that ensure your resources are being used efficiently and that
current projects align with ICD- 10 readiness to eliminate redundancies and streamline the conversion.
Audit Management—Optum pairs expert consulting with innovative technology to help you more
effectively manage claim audit processes and third-party audits. Our package solution allows you to assess
potential risk, manage the audit and appeal processes, monitor deadlines, identify root causes, and prevent
future take-backs—while calculating net financial impact.
Clinical Documentation Improvement Program—Clinical documentation is essential for a well-run
revenue cycle. Optum consulting services offer a Clinical Documentation Improvement Program that provides
accurate analysis and benchmarking, a data quality and operational assessment, education, and monitoring.
The Optum Clinical Documentation Improvement Program can help you identify and mitigate compliance
and reimbursement risk, train hospital medical staff members on correct coding and compliance initiatives,
pinpoint potential RAC issues, and convert your documentation improvement program to ICD- 10 terminology.
Denials Management Program—The Optum Denials Management Program helps you understand your
denials, better manage your claims process, and learn what actions to take for a quicker turnaround time
on your reimbursement. Our consulting services help you to identify, qualify, and most importantly, address
challenges in multiple departments and areas.
For more information:
Ingenix is now OptumInsight™, part of Optum™—
a leading health services business