The Optum Coding Review Module is a component of Optum CAC Professional that automatically compares physician-selected codes to natural language processing (NLP) code assignments.
It applies advanced clinical intelligence to identify coding misalignment and enable improvement.
Benefits
Automates physician-selected coding review
- Enables more complete and accurate coding without additional staff
- Provides configurable business rules and customized workflows
- Leverages Optum NLP to accurately identify encounters needing review
- Performs prospective review to allow real-time correction
Enables targeted action
- Identifies problem areas where physician education is indicated
- Allows you to target specific encounter and patient types
- Helps quantify the effectiveness of your quality program
- Offers flexibility to address specific areas of concern
Improves coding accuracy
- Provides secondary review of physician-coded encounters
- Identifies discrepancies between NLP- and physician-selected codes
- Enables efficient review and modification prior to billing
- Reduces denials and rework
- Preserves revenue
- Mitigates payer audit risk
Product spotlight: Coding Review Module
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