JSON twin: https://www.healthaidb.com/software/optum-coverage-insights.json
Optum
Optum Coverage Insight is an analytics-driven insurance discovery and verification service that identifies undisclosed patient coverage to reduce self-pay accounts and recover revenue.
A commercial, vendor-operated insurance discovery and verification solution that uses data mining, machine learning and predictive analytics plus direct payer connections to screen uninsured and known Medicaid accounts for undisclosed primary coverage, suppress high identity-risk profiles, and return verified payer information (Medicaid, Medicare, commercial) — typically within 24 hours — to improve revenue capture and reduce denials and collections burden.
unknown
2011
P1205
2025-09-07
proprietary/commercial
Contact vendor for pricing; pay-per-account options (percent or fixed fee per benefit unit) and enterprise arrangements; request demo/trial via sales form.
enterprise_quote
product
1.0
{
"company_name": "Optum",
"company_url": "https://www.optum.com",
"company_offices": [
"United States",
"India",
"United Kingdom",
"Ireland",
"Canada",
"Australia",
"Brazil",
"Singapore",
"Philippines"
],
"company_founding": "2011",
"product_url": "https://business.optum.com/en/operations-technology/revenue-cycle-management/patient-access/coverage-insight.html",
"categories": [
"administrative",
"revenue-cycle-management",
"patient-access",
"eligibility-verification",
"analytics"
],
"market_segment": [
"enterprise"
],
"links": [
"https://business.optum.com/en/operations-technology/revenue-cycle-management/patient-access/coverage-insight.html",
"https://marketplace.optum.com/content/dam/change-healthcare/marketplace-assets/outcomes-and-insights/Eligibility-Continuous-Coverage-Discovery.pdf",
"https://www.optum.com/en/",
"https://customercare.optum.com/public/home.html",
"https://business.optum.com/en/support.html",
"https://community.optum.com/home",
"https://www.optum.com/en/privacy-policy.html"
],
"summary": "Optum Coverage Insight is an analytics-driven insurance discovery and verification service that identifies undisclosed patient coverage to reduce self-pay accounts and recover revenue.",
"description": "A commercial, vendor-operated insurance discovery and verification solution that uses data mining, machine learning and predictive analytics plus direct payer connections to screen uninsured and known Medicaid accounts for undisclosed primary coverage, suppress high identity-risk profiles, and return verified payer information (Medicaid, Medicare, commercial) — typically within 24 hours — to improve revenue capture and reduce denials and collections burden.",
"target_users": [
"hospital revenue cycle teams",
"patient access staff",
"billing and collections teams",
"health system administrators",
"providers",
"payers (integration/partners)",
"third-party billing services"
],
"specialties": [
"revenue cycle management",
"patient access",
"medical billing",
"payment integrity",
"claims management"
],
"regions_available": [
"United States",
"United Kingdom",
"Canada",
"Australia",
"India",
"Brazil",
"Singapore",
"Ireland",
"Mexico",
"New Zealand"
],
"languages_supported": [
"English",
"Spanish",
"Chinese (Mandarin)",
"Portuguese"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing; pay-per-account options (percent or fixed fee per benefit unit) and enterprise arrangements; request demo/trial via sales form.",
"license": "proprietary/commercial",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Insurance discovery / coverage identification for self-pay accounts",
"Advanced data mining and machine learning for payer matching",
"Predictive analytics and hit-rate scoring",
"Demographic and historical profile enrichment (names, addresses, employers)",
"Direct payer and third-party connections for verification",
"Identity-risk suppression (rejects high-risk profiles)",
"Support for CMS anti-phishing requirements",
"Prioritization of billable coverage / payer targeting",
"Continuous/real-time screening (results typically within 24 hours)",
"Reporting / analytics on uncovered coverage and recovery impact"
],
"optional_modules": [],
"integrations": [
"Medicaid",
"Medicare",
"Commercial payers",
"Direct payer connections (Optum payer network)"
],
"data_standards": [],
"api_available": "unknown",
"system_requirements": "",
"compliance": [
"CMS anti-phishing mandate",
"HIPAA"
],
"certifications": [],
"security_features": [
"Identity-risk suppression",
"Data validation / screening"
],
"privacy_features": [
"Profile suppression to reduce PHI/identity risk"
],
"data_residency": "",
"customers": [],
"user_reviews": [],
"ratings": [],
"support_channels": [
"24x7",
"client support portal (ticketing)",
"community"
],
"training_options": [
"documentation (e-book)",
"video/recorded demos",
"live_online (request a demo)"
],
"release_year": "",
"integration_partners": [],
"id": "P1205",
"slug": "optum-coverage-insights",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/optum-coverage-insights.json"
}
}