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Optum Medical Practice Management Software

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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.

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
  • Monthly subscription
  • Yearly subscription per user
  • Monthly site license
  • Yearly site license
  • Metered per minute
  • Flat fee
  • Percentage-based (% of collections or claims)
  • Fee-based (fixed $/claim)
  • Hybrid (combination of % and fixed amount/claim)
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)
  • Outpatient care providers
  • Single office
  • Multiple offices
  • 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
  • Stand-alone
  • EMR/EHR
  • Medical practice management
  • Medical billing
User Authentication
  • User authentification
  • Role-based access
  • Manage access permissions
Billing Features
  • Payment Reminders
  • Billing Estimates
  • Customizable Fee Schedules
  • Automatic Payment Posting
  • Batch-process Patient Billing
  • Assignment of Benefits (AOB)
  • Applied to Deductible (ATD)
  • Ambulatory Payment Classification (APC)
  • Explanation of Benefits (EOB)
  • Electronic Remittance Advice (ERAs)
  • Online Bill Payment
  • Credit Card Processing
  • Collection Letters
  • 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
  • ASA Codes
  • Automatic Codes Updates
  • Automatic Payer Rules Updates
Scheduling Features
  • Online Patient Scheduling
  • Physician Scheduling
  • Staff Scheduling
  • On-Call Scheduling
  • Facility Scheduling
  • Drag & Drop Scheduling
  • Multi-Resource Scheduling
  • Appointment Management
  • No-Show Tracking
  • Recurring Appointments
  • Appointment Reminders
  • Intelligent Waitlists
  • Check-In & Checkout
  • Notes
Document Management
  • Medical Record Management
  • Patient Statements
  • Patient Invoices
  • Lab Reports
  • Consultation Report Integration
  • EHR/EMR Integration
Patient Management Features
  • Patient Portal
  • e-Prescribing and Refills
  • Lab Orders & Results
  • Patient Medical History
  • Drug Interaction and Allergies
  • Insurance Information Details
  • Coverage Verification
  • Patient Payment History
Claim Management Features
  • Insurance Eligibility Verification
  • Claim Scrubbing
  • Claim Processing
  • Batch Claim Processing
  • Integrated Claims Correction
  • Electronic Claim Submission
  • Paper Claim Submission
  • Preferred Clearinghouse
  • Claim Follow-up
  • Claim Status Tracking
  • Denied Claims Management
  • Collection Agency Reporting
Reporting
  • Financial Reports
  • Payments Reporting
  • A/R Reports
  • Revenue Reports
  • Payer Performance Reports
  • First-Pass Resolution Rate Report
Deployment
  • Web-based
  • Installed (on-premise)
Supported Devices
  • Desktop
  • Mobile
  • Tablet
  • iPad
  • Touchscreens
Certifications
  • Meaningful Use Certified
  • ONC-ATCB
  • CCHIT
  • EHNAC Accredited
  • Microsoft Gold Certification
  • Surescripts Certification
  • None
HIPAA Compliance
  • Yes
  • No
  • In process
System Compliance
  • Office of Inspector General (OIG) Compliance
Service Terms Offered
  • Commitment Free
  • Free Setup
  • Free Cancellation
  • Money Back Guarantee
  • Month-to-Month Option
  • Keep Original Number
  • Customizable Plans
  • Account Manager
  • Free In-Network Calls
  • Unlimited Minutes
  • International Calls
  • Reduced Price for Multiple Users
Mobile Apps Offered
  • None
  • iOS
  • Android
Mobile friendly?
  • Yes
  • No
Service Terms Offered
  • Commitment Free
  • Free Setup
  • Free Cancellation
  • Money Back Guarantee
  • Month-to-Month Option
  • Keep Original Number
  • Customizable Plans
  • Account Manager
  • Free In-Network Calls
  • Unlimited Minutes
  • International Calls
  • Reduced Price for Multiple Users
Support Features
  • FAQs Section
  • Tutorials
  • Telephone Support
  • Email Support
  • 24/7 Support
  • Online Chat
  • Forum
  • In-Person Training
  • Social Media
  • Knowledge Base
  • Webinars

Pricing

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