CASE STUDY
Plugging payment leakage
Validate claims payment decisions with a secondary editor.
Minimize overpayments and capture savings
A health plan in California wanted to rein in costs and improve process efficiency. By deploying system edits and targeted custom edits, Optum helped this plan target leakage gaps. The result was $13.50 PMPY savings to the bottom line.
Claims Edit System (CES) Second Pass
Learn how our second-pass editor helps health plans avoid payment leakage with a second line of defense. Health plans can use CES Second Pass to prevent costly overpayments, improper payments, and delayed payments and recoveries.
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