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Explore our online Digital Coding Options 

Staying ahead of the coding curve 

Working Smart! Using Medical Reference Engine to improve your regulatory knowledge.

This educational session will demonstrate a smarter way to search for information using Optum360’s web based Medical Reference Engine. A proprietary repository of governmental regulations from the Centers for Medicare and Medicaid Services (CMS) and 26 (and growing) state Medicaid associations is the core of the Medical Reference Engine. Additional information includes guidelines from other government agencies including the Federal Register, Code of Federal Regulations, and Optum360 proprietary tools such as DRG decision trees.  Supplementing this information we include 36 Optum360 publications as ebook resources with more to be integrated.

Dates: March 3rd, 1:00pm ET

Correct Mapping is a MUST for ICD-10 Preparation

The ICD10 deadline is once again upon us.   While many of us still have some apprehension about the deadline, we cannot afford not to prepare should the industry make this transition in 2015.  Preparation is the key to avoiding lost revenue and workflow, regardless of the type of organization we manage, and the key to preparation is mapping.   While many of us will simply “natively” code with the ICD10 code set (search clinical terms that match ICD-10 codes – not code to ICD-9, and then map to ICD-10), using mapping to prepare for ICD-10 is a must.  Why?  There is no substitute for mapping to understand the code sets, understand how the match to the ICD-9 codes we are familiar with, and to understand the specificity and clinical documentation preparation we need to avoid lost revenue.  Don’t rely on CMS or your vendors to prepare you.  Understand the best clinical mappings for your ICD9 codes and map to prepare your documentation and systems.   Let Optum360 show you how.  

Dates: April 7th, 1:00pm ET

Four focus areas to strengthen and enhance coding performance

Now more than ever, the small hospital is faced with external regulatory and payer pressures which translate into increasing demands on coding departments. Higher staffing costs, higher technology costs and higher responsibility mean higher expectations.

During this event we will discuss four standard areas coding leaders can focus on to increase their level of performance: People, Processes, Technology and Priorities.

Learning objectives:

  • Understand the importance of assessing and managing the current coder workflow to prepare for the implementation of Computer Assisted Coding (CAC) and ICD-10
  • What can be done to strengthen and enhance your current coding program performance
  • How to best prepare your coding program for the impact of ICD-10

Date: January 29, 1:00 PM ET - View recorded presentation

Avoid RAC Take-backs and Reduce Administrative Costs Associated with RAC Audit Processing

This year brings the first significant break in RAC activity for health care providers. Now is the time to take advantage of the RAC break to assess current programs, review historical data and centralize audit management processes. The steps taken now to improve RAC processing will drive significant returns when the RACs reconvene.

This webinar will discuss these steps and how Optum Audit Management solutions maximize growth opportunities by identifying and mitigating risk and protecting profits.

This event will review:

  • Where you stand in the audit process
  • Key areas of improper payment
  • Top ways to avoid these issues
  • What can be done to prepare for a RAC Audit
  • What to do if you are audited
  • Impact of medical necessity changes
  • Top ways to maximize workflow and minimize future audit risk

View recorded presentation

Compliance Checking - Reduce bad debt, denials, and unnecessary write offs

Learn how Optum Compliance Checking can help you prevent mistakes on the front end of a claim cycle, ensuring that you're not banking on phantom dollars at the back end.

Dates: View recorded presentation

Real Strategies for Small and Rural Hospitals. Create a Plan with Optum Billing Solutions to Defend Against Financial Pressures.

This information-packed session will help you better understand the unique financial challenges faced by small and rural hospitals and provide strategies to offset the financial impact throughout your organization. In this session, you will:  

  • Explore the differences in rural and urban patient care
  • Review five key things to know about rural hospitals and the fiscal challenges they face, according to a recent report from the Wall Street Journal
  • Find out how the Optum Billing Solutions gives you control over your coding, compliance and reimbursement data and processes to help you to achieve your revenue goals
  • Consider critical tasks to allow for transparency of information across departments and real-time visibility into what is happening at your facility
  • Learn how small hospitals can benefit from the rural hospital insights

Take advantage of this opportunity to identify potential oversights in your plan and ensure greater preparedness.      

View recorded presentation

Audit Management — Maximize Your Workflow and Minimize Take-backs   

Learn why Audit Management from Optum is your solution to maximizing your workflow and minimizing take-backs. This product showcase will outline the risks and recommend solutions that will automate RAC and all payer audit requests.

The product presentation will cover such topics as: 

  • Submission: Enables electronic record submission through esMD module
  • Claim query: Identifies exposure and potential RAC risk
  • Auditing: Manages audit requirements, simplifies audit compliance and automatically tracks appeals
  • Reporting: Provides 29 executive-level key performance indicators (KPIs)  

View recorded presentation

Arming Your Hospital with Tools to Stay Financially on Track with Federal and Payer-specific Requirements

Hospitals are reeling from financial and compliance pressures. A combination of bad debt, newly covered patients, changing reimbursement models and the risk of denials place already slim operating margins in greater peril. It’s easy to see why more than 70% of hospitals are reporting a loss in revenue.

Optum360 can help your hospital achieve the transparency, visibility and consistency needed to comply with federal and payer-specific requirements and, when necessary, manage the audit process.

This webinar will discuss how Compliance Checking and Audit Management solutions from Optum maximize growth opportunities by identifying and mitigating risk and protecting profits.

Learn how to:   

  • Maximize workflow and minimize future audit risk
  • Show you where you stand in the audit process
  • Dramatically reduce medical necessity denials to maximize revenue 
  • Automate to give time back to your employees and increase employee satisfaction 

Additionally, special guest Shelly Walters, Associate Director of ICD-10 & Industry Driven Solutions at Optum, shares hospital recommendations for ICD-10 preparedness and reflects on the recent delay.  

View recorded presentation

Prepare for ICD-10 and Reduce Medical Necessity Write-offs  

Most of us have heard the maxim "work smarter, not harder," and that’s never been more true than now with the ICD-10 transition on the horizon.    

Join us for an hour long webinar that will outline Optum Compliance Checking and Audit Management solutions that can help you work smarter by helping you reduce medical necessity denials and boost oversight of RAC, CMS and other payer audits to minimize future recoveries.

Compliance checking 

  • Quick and easy web-based format, accessible anywhere 
  • Achieve up to 98% decrease in medical necessity denials
  • Automate and store ABNs with real-time policy updates

Audit management

  • Analyze claims data to prevent RAC audits and determine financial risk
  • Understand exposure areas, determine audit outcomes and generate email alerts 
  • Track and manage workflow processes through the lifecycle of an audit
  • Accelerate audit resolution with the esMD module. Electronically submit requested records to audit contractors, eliminating delays associated with the paper process.
  • Be aware of scheduled RAC recoupment

View recorded presentation


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