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Optum Reviews & Overview

What is Optum?

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.


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. 

Company:Optum, Inc

Optum Pricing

Optum Medical Practice Management
per user / per month
Optum Pricing Details

Optum Key Features

Service Terms Offered
  • Month-to-Month Option
  • Customizable Plans
  • Reduced Price for Multiple Users
Support Features
  • FAQs Section
  • Tutorials
  • Telephone Support
  • Email Support
  • 24/7 Support
  • Online Chat
  • Social Media
  • Knowledge Base
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
  • Substance Abuse Agencies
  • Medicaid Waiver Providers
  • Medical Billing Centers
  • Outsourced Billing Services
  • Behavioral Health
  • Hospital
  • Urgent Care
  • Medical practice management
User Authentication
  • User authentification
  • Role-based access
  • Manage access permissions
  • Meaningful Use Certified
  • EHNAC Accredited
HIPAA Compliance
  • Yes
Billing Features
  • Billing Estimates
  • Assignment of Benefits (AOB)
  • Applied to Deductible (ATD)
  • Ambulatory Payment Classification (APC)
  • Electronic Remittance Advice (ERAs)
  • Online Bill Payment
  • Batch-process Patient Billing
  • Credit Card Processing
  • Collection Letters
  • EDI Rules Manager
Medical Billing Codes
  • ICD-10
  • CPT Codes
  • ASA Codes
Scheduling Features
  • Online Patient Scheduling
  • Physician Scheduling
  • On-Call Scheduling
  • Facility Scheduling
  • Appointment Management
  • Recurring Appointments
  • Appointment Reminders
  • Multi-Resource Scheduling
  • Check-In & Checkout
Document Management
  • Medical Record Management
  • EHR/EMR Integration
  • Patient Statements
  • Patient Invoices
  • Consultation Report Integration
Patient Management
  • Patient Portal
  • Lab Orders & Results
  • Patient Medical History
  • Insurance Information Details
  • Coverage Verification
  • Patient Payment History
  • Drug Interaction and Allergies
Claims Management
  • Claim Processing
  • Batch Claim Processing
  • Claim Follow-up
  • Insurance Eligibility Verification
  • Denied Claims Management
  • Integrated Claims Correction
  • Collection Agency Reporting
  • Claim Status Tracking
  • Paper Claim Submission
  • Financial Reports
  • A/R Reports
  • Revenue Reports
  • Payer Performance Reports
  • First-Pass Resolution Rate Report
System Compliance
  • OIG
Optum Features Details

Optum Media


Optum Reviews

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