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Optum - Medical Practice Management

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Details

Optum Revenue Cycle Management is a software package from Optum, Inc. that offers top-notch medical management solutions to healthcare practitioners aimed at creating greater success in revenue performance and achieve greater control of practice revenue cycle. Optum, Inc. created Optum360 - a trademark that represents its platform aiming at creating a complete turnaround practice revenue cycle understanding and operationalization. Optum360™ focus on achieving best RCM by building practice and patient transparency, improve margin performance and modernizing practice processes by either improving, optimizing, transforming or innovating practice existing system. To achieve all this promise to its clients, Optum™ employs experienced professional and uses industry research to model best RCM models and pathways.

Features

Optum RCM package is modeled around a revenue cycle pathway module which features margin performance improvement framework, Payer-provider collaboration enhancement framework geared towards improving relationship between providers and payers, patience experience improvement framework, a framework for improving providers' revenue cycle compliance to regulatory provisions and a transparency improvement component. This components are achieved through expert consultation, running training programs and adoption of advance RCM software solutions.

Optum RCM also comes with a comprehensive Optum claims solution designed to inform healthcare practices, health systems and hospitals and build a knowledgebase medical industry transformations, trends and demands. This is one of the main unique features of Optum distinguishing it from other RCM providers and putting Optum clients ahead other players.

The focus on creating a strong organization learning culture and employing market research to inform best practices not only builds a learning culture for vendors but also creates a unique relationship between Optum RCM and vendors.

Unlike many RCM providers who simply offer standalone software applications for adoption by vendors or a simple/complex service outsourcing package, Optum360 RCM a comprehensive and informative collaboration structure, operationalization framework and value/culture development and management framework that eventually increases the level of client and staff ownership of the RCM system and secures long term sustainability of the adopted system, even with exist of Optum RCM provider. 

Features

Pricing Model
  • Monthly subscription per user
  • Yearly subscription per user
  • Metered per minute
  • Monthly site license
  • Yearly site license
  • Flat fee
  • Monthly subscription
  • Percentage-based (% of collections or claims)
  • Fee-based (fixed $/claim)
  • Hybrid (combination of % and fixed amount/claim)
Target Company Size
  • Startup
  • Small-to-Medium Business
  • Enterprise
Service Terms Offered
  • Commitment Free
  • Free Setup
  • Free Cancellation
  • Money Back Guarantee
  • Month-to-Month Option
  • Keep Original Number
  • Customizable Plans
  • Free In-Network Calls
  • Unlimited Minutes
  • International Calls
  • Reduced Price for Multiple Users
  • Account Manager
Mobile Apps Offered
  • None
  • iOS
  • Android
Support Features
  • FAQs Section
  • Tutorials
  • Telephone Support
  • Email Support
  • 24/7 Support
  • Online Chat
  • Forum
  • In-Person Training
  • Social Media
  • Knowledge Base
  • Webinars
Compatible Operating System(s)
  • Windows
  • iOS
  • Linux
  • Mac
  • Android
Deployment
  • Hosted/Cloud
  • On-Premise
  • Mobile
Supported Devices
  • Mobile
  • Tablet
  • Touchscreens
  • Desktop
  • iPad
Targeted Users
  • Primary care (MDs, DOs)
  • Specialists (DC, OD, PT, PhD, LCSW, etc)
  • Small/private practices
  • Mid-sized to large practices
  • Inpatient care organizations (hospitals, etc)
  • Single office
  • Multiple offices
  • Outpatient care providers
  • Substance Abuse Agencies
  • Medicaid Waiver Providers
  • Medical Billing Centers
  • Outsourced Billing Services
Specialties
  • Allergy
  • Anesthesiology
  • Bariatric Surgery
  • Behavioral Health
  • Breast surgery
  • Cardiology
  • Chiropractic
  • Dentistry
  • Dermatology
  • Emergency medecine
  • Endocrinology
  • ENT
  • Family Medecine
  • Gastroenterology
  • General Surgery
  • Geriatrics
  • Hematology
  • Hospital
  • Infectious Disease
  • Internal Medecine
  • Long-Term Care
  • Nephrology
  • Neurology/Neurosurgery
  • Occupational Medecine
  • Oncology
  • Ophtalmology
  • Optometry
  • Orthopedics
  • Pathology
  • Pediatrics
  • Physical Therapy
  • Plastic Surgery
  • Podiatry
  • Psychiatry
  • Psychology
  • Pulmonology
  • Radiology
  • Rheumatology
  • Sleep Medecine
  • SurgiCenter
  • Urgent Care
  • Urology
  • Vascular Surgery
Integrated software suite
  • EMR/EHR
  • Stand-alone
  • Medical practice management
  • Medical billing
User Authentication
  • User authentification
  • Role-based access
  • Manage access permissions
Certifications
  • ONC-ATCB
  • CCHIT
  • Meaningful Use Certified
  • None
  • EHNAC Accredited
  • Microsoft Gold Certification
  • Surescripts Certification
HIPAA Compliance
  • Yes
  • No
  • In process
Billing Features
  • Payment Reminders
  • Billing Estimates
  • Automatic Payment Posting
  • Assignment of Benefits (AOB)
  • Applied to Deductible (ATD)
  • Ambulatory Payment Classification (APC)
  • Explanation of Benefits (EOB)
  • Electronic Remittance Advice (ERAs)
  • Online Bill Payment
  • Batch-process Patient Billing
  • Credit Card Processing
  • Collection Letters
  • Customizable Fee Schedules
  • EDI Rules Manager
Medical Billing Codes
  • ICD-9
  • ICD-10
  • CPT Codes
  • CPT-4
  • CPT Modifiers
  • CDT Codes (dental)
  • NDC Drug Codes
  • DRG Medicare Codes
  • Taxonomy Codes
  • Medical Diagnostic Codes
  • HCPCS Codes
  • Evaluation Codes
  • IFC Codes
  • DSM-IV Codes
  • Automatic Codes Updates
  • Automatic Payer Rules Updates
  • ASA Codes
Scheduling Features
  • Online Patient Scheduling
  • Physician Scheduling
  • Staff Scheduling
  • On-Call Scheduling
  • Facility Scheduling
  • Drag & Drop Scheduling
  • Appointment Management
  • No-Show Tracking
  • Recurring Appointments
  • Appointment Reminders
  • Notes
  • Intelligent Waitlists
  • Multi-Resource Scheduling
  • Check-In & Checkout
Document Management
  • Medical Record Management
  • EHR/EMR Integration
  • Patient Statements
  • Patient Invoices
  • Consultation Report Integration
  • Lab Reports
Patient Management Features
  • Patient Portal
  • e-Prescribing and Refills
  • Lab Orders & Results
  • Patient Medical History
  • Insurance Information Details
  • Coverage Verification
  • Patient Payment History
  • Drug Interaction and Allergies
Claim Management Features
  • Claim Scrubbing
  • Claim Processing
  • Batch Claim Processing
  • Claim Follow-up
  • Insurance Eligibility Verification
  • Denied Claims Management
  • Integrated Claims Correction
  • Collection Agency Reporting
  • Claim Status Tracking
  • Preferred Clearinghouse
  • Electronic Claim Submission
  • Paper Claim Submission
Reporting
  • Financial Reports
  • Payments Reporting
  • A/R Reports
  • Revenue Reports
  • Payer Performance Reports
  • First-Pass Resolution Rate Report
System Compliance
  • Office of Inspector General (OIG) Compliance
Deployment
  • Web-based
  • Installed (on-premise)
Price
  • 1 - Inexpensive
  • 2
  • 3 - Moderate
  • 4
  • 5 - Expensive
Features
  • 1 - Limited features
  • 2
  • 3 - Moderate
  • 4
  • 5 - Full featured

Pricing

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