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Advances in completeness and accuracy expected to reduce the number
of claims-processing errors and appeals, improve care provider and
patient experiences, avoid unnecessary costs
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Availity will implement Optum’s Advanced Claim Editing (ACE)
solution into its Availity Health Information Network; Optum will use
Availity’s network to connect to commercial and government health
plans nationwide
Optum, a leading information and technology-enabled health services
business, and Availity, the nation’s largest real-time health
information network, will collaborate to help improve the completeness
and accuracy of health insurance claims, and reduce claims-processing
errors and appeals.
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The partnership will help more than 900,000 care providers who use
practice-management systems to exchange real-time administrative,
financial and clinical information with government and commercial health
plans nationwide through the Availity Health Information Network.
The companies announced that Availity will implement Optum’s Advanced
Claim Editing (ACE) solution as a component of the Availity Health
Information Network, and Optum will use the Availity Health Information
Network to connect to commercial and government health plans nationwide.
By using Optum’s ACE solution, participating health plans can give care
providers timely notifications and feedback on actionable errors or
information gaps that often trigger claim denials. This means care
providers are more likely to submit accurately completed claims and
health plans can subsequently reduce claims-processing times and
mitigate appeals that require costly investigation and recovery efforts.
Also, patients are better able to accurately understand their financial
responsibilities.
“By streamlining the claims process for health plans and care providers,
ACE can take unnecessary cost and friction out of the health system,
while improving patient experiences,” said Bill Miller, CEO of
OptumInsight.
Optum will move a significant volume of its third-party commercial and
government transactions to the Availity Health Information Network,
thereby increasing Availity’s scope from 2 billion to more than 3
billion transactions annually. Through this partnership Availity will
drive greater administrative cost savings for health plans by further
streamlining engagement with their care provider networks.
“Availity’s rich feature-set and extensive network of care providers and
health plans is an ideal home for Optum’s ACE solution,” said Russ
Thomas, CEO of Availity. “Availity offers a single point of engagement
for health plans and care providers, which leads to improved payment
turnaround and more accurate claims submissions. We are delighted to
have been selected by Optum to connect its industry-leading ACE solution
to our broad national network of health plans.”
About Optum
Optum is a leading information and
technology-enabled health services business dedicated to helping make
the health system work better for everyone. With more than 100,000
people worldwide, Optum delivers intelligent, integrated solutions that
help to modernize the health system and improve overall population
health. Optum is part of UnitedHealth Group (NYSE:UNH). For more
information, visit www.Optum.com.
About Availity
As an industry-leading, HITRUST-certified
health care information technology company, Availity serves an extensive
network of health plans, providers, and technology partners nationwide
through a suite of dynamic products built on a powerful, intelligent
platform. Availity integrates and manages the clinical, administrative,
and financial data needed to fuel real-time coordination between
providers, health plans, and patients in a growing value-based care
environment. Facilitating over 7 million transactions daily, Availity’s
ability to provide accurate, timely, and relevant information is vital
to the financial success of its clients.
For more information, including an online demonstration, please visit www.availity.com
or call 1.800.AVAILITY (282.4548).
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