JSON twin: https://www.healthaidb.com/software/optum-ar-and-denial-management.json
Optum
Optum A/R Recovery and Denial Management is a managed services and technology offering that combines specialized recovery teams with automation platforms to reduce claim denials, accelerate accounts receivable recovery, and improve revenue cycle performance.
A combined managed-services and software solution from Optum that uses platforms such as Payment Integrity Compass and Revenue Performance Advisor plus tenured recovery specialists to automate claim classification and batching, populate appeals workflows, perform root-cause denial analytics, model contracts, check real-time eligibility, and deliver configurable dashboards and reporting to reduce denials and shorten A/R days across payer types.
yes
2011
US and global deployment/managed options (contact vendor for region-specific hosting)
P1203
2025-09-07
commercial proprietary
contact vendor for pricing and engagement/tier options
enterprise_quote
product
1.0
{
"company_name": "Optum",
"company_url": "https://www.optum.com",
"company_offices": [
"United States",
"Brazil",
"India",
"Ireland",
"United Kingdom"
],
"company_founding": "2011",
"product_url": "https://business.optum.com/en/operations-technology/revenue-cycle-management/reimbursement/ar-monitoring-performance-services.html",
"categories": [
"administrative",
"revenue cycle management",
"billing",
"claims management",
"denial management",
"managed services",
"analytics"
],
"market_segment": [
"enterprise",
"providers",
"payers"
],
"links": [
"https://business.optum.com/en/operations-technology/revenue-cycle-management/reimbursement/ar-monitoring-performance-services.html",
"https://business.optum.com/en/operations-technology/revenue-cycle-management.html",
"https://business.optum.com/en/insights/denials-index.html",
"https://business.optum.com/en/about-us.html",
"https://elion.health/products/optum-ar-and-denial-management",
"https://business.optum.com/content/dam/o4-dam/resources/pdfs/sell-sheets/comprehensive-denial-avoidance.pdf",
"https://www.optum.com/en/privacy-policy.html",
"https://business.optum.com/en/support.html"
],
"summary": "Optum A/R Recovery and Denial Management is a managed services and technology offering that combines specialized recovery teams with automation platforms to reduce claim denials, accelerate accounts receivable recovery, and improve revenue cycle performance.",
"description": "A combined managed-services and software solution from Optum that uses platforms such as Payment Integrity Compass and Revenue Performance Advisor plus tenured recovery specialists to automate claim classification and batching, populate appeals workflows, perform root-cause denial analytics, model contracts, check real-time eligibility, and deliver configurable dashboards and reporting to reduce denials and shorten A/R days across payer types.",
"target_users": [
"revenue cycle managers",
"billing staff",
"denial management teams",
"coding specialists",
"hospital/health system finance leaders",
"ambulatory practice administrators",
"third-party billing services",
"payers (integration/coordination)"
],
"specialties": [
"revenue cycle management",
"medical billing",
"claims denial management",
"hospital/health system finance",
"ambulatory practice revenue"
],
"regions_available": [
"United States",
"United Kingdom",
"Canada",
"India",
"Brazil"
],
"languages_supported": [
"English",
"Spanish"
],
"pricing_model": "enterprise_quote",
"pricing_details": "contact vendor for pricing and engagement/tier options",
"license": "commercial proprietary",
"deployment_model": [
"SaaS",
"managed_services",
"hybrid"
],
"os_platforms": [
"Web"
],
"features": [
"Claims denial identification and management",
"Accounts receivable (A/R) recovery and backlog remediation",
"Automated, configurable workflow for denial remediation",
"Root cause analysis for denial prevention",
"AI/ML-driven denial prediction (claims remittance analysis)",
"Pre-populated appeal letter generation",
"Analytics and actionable reporting (operational KPIs)",
"Prioritization/triage of accounts and denials",
"Supplemental/outsourced recovery staffing (HFMA-certified specialists)",
"Integration into existing revenue cycle workflows",
"24/7/reduced turnaround operational support"
],
"optional_modules": [
"Denials prevention analytics",
"Advanced predictive modeling for at-risk claims",
"Custom reporting and dashboards",
"Supplemental staffed recovery teams"
],
"integrations": [
"Electronic health record (EHR) systems",
"Practice management systems",
"Billing / clearinghouse / revenue cycle systems",
"Payer remittance and eligibility feeds",
"Optum Revenue Cycle APIs / Marketplace APIs",
"Third-party billing vendors"
],
"data_standards": [
"FHIR",
"HL7 v2",
"X12 EDI (837/835)"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA",
"HITECH",
"SOC 2"
],
"certifications": [],
"security_features": [
"Encryption (in transit and at rest)",
"Role-based access control (RBAC)",
"SSO/SAML support",
"Audit logging"
],
"privacy_features": [
"Business Associate Agreement (BAA) available",
"Data minimization and controlled access"
],
"data_residency": "US and global deployment/managed options (contact vendor for region-specific hosting)",
"customers": [],
"user_reviews": [],
"ratings": [],
"support_channels": [
"support portal",
"sales contact form",
"phone",
"email"
],
"training_options": [
"documentation",
"white papers",
"webinars",
"live_online"
],
"release_year": "",
"integration_partners": [
"Payment Integrity Compass",
"Revenue Performance Advisor",
"EHR and practice management systems"
],
"id": "P1203",
"slug": "optum-ar-and-denial-management",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/optum-ar-and-denial-management.json"
}
}