Program Integrity Solutions for Government Agencies

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Optum^® helps Medicaid agencies prevent, detect, investigate and recover improper payments throughout the claims cycle — from prepay to postpay. Our comprehensive program integrity suite is backed by experienced staff, saving Medicaid agencies millions of dollars each year.

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From prevention to recovery, our Medicaid-tuned analytics deliver actionable intelligence.

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Advanced detection analytics
designed for Medicaid

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Developed from 30 years
of program integrity expertise

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Help identify and recover
billions each year

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Explore our solutions

Claims Editing Services

We help state agencies maximize auditing capabilities.

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Fraud, Waste and Abuse Services

Prevent, detect, investigate, recover claim payment errors.

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Advanced Communication Engine

Prevent claim inefficiency and lower administrative costs.

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Predictive analytics to reduce fraud

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Medicaid PI best practices: Working with MCOs

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