Optum CDI and coding solutions

Optum® Enterprise CAC applies clinically intelligent Optum® NLP to review medical records and deliver comprehensive, accurate code suggestions. It optimizes hospital coding operations and increases efficiency as it reduces claim denials, costly rework and lost revenue.

Enterprise CAC and CDI 3D share a single technology platform that enables greater efficiency, consistency and communication across departments. Targeted modules and capabilities help address specific challenges and optimize operations.

Modules enhance, simplify and streamline processes

• The Optum® Coding and Reimbursement Module provides easy access to all of our coding tools to support accurate case completion. It includes encoders, comprehensive edits and medical necessity indicators, and full access to our Medical Reference Engine.
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• The Optum360® Medical Reference Engine gives coding and CDI professionals access to a database of reference books, Medicare and Medicaid documents, Coders Desk References, Dr. Z’s Medical Coding Series: Interventional Radiology, CPT Assistant and AHA Coding Clinic.
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• Optum® Audit and Compliance Manager identifies cases at risk for denial and automatically routes them through efficient workflow for review. It enables hospitals to proactively target pre-bill audits, prevent downstream denials and preserve revenue integrity.
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• The Optum® Workflow Module streamlines workflow by providing flexible work queue parameters; prioritizes CDI worklists based on potential impact; assigns cases to coders based on your customized business rules; and boosts CDIS, coder and manager productivity.
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• Optum® LYNX Infusion Charging Module uses a proprietary algorithm to translate infusion and injection services to the appropriate charging terms to help hospitals calculate appropriate and consistent charges.