Optum

Current Time Inside Cache Tag Helper: 9/30/2020 3:28:58 PM and Model.VendorId = 61201

Optum's Current COVID-19 Response and Solutions

The following information was supplied by the vendor and has not been validated by KLAS.

Advisory Services
Services for rapid response and crisis management, resource modeling, telework, and telehealth

  • Rapid Response Leadership: Expertise in rapid response and crisis management situations in relation to COVID-19.
  • Resource Modeling: Help physician practices project the spread of COVID-19 infection in local markets and model supply and hospital bed availability.
  • Remote Workforce Readiness: Consulting services to help providers transition nonessential staff to working remotely. Focus is on minimizing impact to the health system while helping to keep workforce healthy and safe.
  • Telehealth and Digital Health Tools: Multidisciplinary digital and telehealth change management expertise to help providers think through IT impacts, patient engagement, rollout, clinical training, costs, resulting billing and reimbursement changes, and risk and compliance issues.

Clinical Services
Services for patient helpline, chronic care management, and employee assistance program

  • Patient Helpline: 24/7 patient access for assessing health concerns (e.g., determining when to see a physician). Clinical nurse support services include clinical triage, proprietary triage tool, patient decision support, patient education, prescription support and refills, and physician preferences and escalation. Nonclinical customer services include scheduling, referrals, and navigation. Services delivered via a unified scaled infrastructure through EMR integration, workflow tool, data, and analytics.
  • Chronic Care Management: Reimbursable care coordination via remote care coordination in practices. Services include identification and stratification, outreach and enrollment, monthly care coordination, and patient billing. Fully outsourced, technology-enabled services include staffing, ongoing process design and improvement, and a unified scaled infrastructure through agent workflow technology, EMR integration, patient engagement tools, and analytics as well as performance management, compliance, and value reporting.
  • Employee Assistance Program (EAP): Master’s-level specialist support by phone. In-person, online, and worksite consultations also available. Provider network of 105,000 NCQA-accredited and tiered counselors, with EAP and critical incident services in more than 150 countries. Consumer portal has won awards and is URAC accredited. Users can access screeners, self-help programs, videos, and articles. Search for providers or request authorization online. A new mobile app further increases utilization and awareness.

Optum Data Exchange
Links providers and payers bidirectionally to securely deliver clinical data where it is needed to support value- and risk-based agreements

Aggregates, transforms, and distributes clinical data for providers and payers. ODX works on the principle of “connect-once, usemany” with over 2,400 clinical interfaces and more than 100 EHR integrations. ODX links providers and payers bidirectionally to securely deliver the clinical data where the data is needed in the format it is needed to support value and risk-based agreements. Today, ODX is processing over $2 billion clinical transactions per year.

Research
Complimentary access to COVID-19 readiness resources

  • Advisory Board Research: The Advisory Board has compiled resources for COVID-19 readiness to help ensure the safety of provider staff and patients. Access is complimentary.

Performance Analytics
Identify at-risk populations

Identify at-risk populations:

  • Identify patients in CDC at-risk cohort to:
    • Administer vaccine for those without
    • Prioritize testing of care team to reduce exposure risk
    • Circulate CDC guidelines to prevent exposure
    • Coordinate PCPs with at-risk patient panels to ensure proactive outreach letting them know next steps to prevent exposure
    • Understand how to staff properly if there were to be a significant outbreak in at-risk populations by clinic
  • Identify patients with compromised immune system to:
    • Administer flu vaccine for those without
    • Prioritize testing of care team to reduce exposure risk
    • Circulate CDC guidelines

Sanvello
Self-help app for cognitive behavioral therapy

Top-rated self-help app that uses clinically validated techniques such as cognitive behavioral therapy (CBT)—a type of psychotherapy that has been shown to be especially effective for individuals experiencing high levels of stress or symptoms of anxiety and depression. Sanvello empowers individuals to engage with activities to improve their mental health from the convenience of their mobile device anytime, anywhere—helping relieve symptoms and build life skills that can reduce potential high-cost interventions in the future. Optum is offering free premium access to help people manage the mental health impacts of COVID-19. Sanvello can be downloaded from the App Store or Google Play.

Revenue Cycle Management
Physician advisor solutions, coding and documentation services, and coding and CDI technology

  • Physician Advisor Solutions: Physician advisor expertise, evidence-based medical research, and sophisticated technology to support appropriate reimbursement and accurate quality reporting within your organization. We team up with your physicians to pinpoint improvement opportunities. Our on-site and remote services can apply artificial intelligence (AI) to drive timely patient-status determinations. We deliver greater efficiency, accuracy, and integrity to your utilization review and clinical documentation improvement processes and outcomes. Our Physician Advisor Services can help you reduce denial rates, manage appeals, minimize audit risk, and ensure appropriate reimbursement. The services can also relieve the administrative burden on physicians, freeing them to devote more time to patient care.
  • Coding and Documentation Services: Optum360 Coding and Documentation Services help eliminate the challenges associated with staffing, retention, and training while leading practice standardization. We work with your organization so that all services are coded in a timely fashion while maintaining quality and optimal DNFB levels. Our coding services are powered by industry-leading, computer-assisted coding (facility and professional) and outpatient charging applications for greater efficiency and accuracy. Our dedicated coding staff can bring you multiple tiers of coding support and provide services for organization types ranging from large health care provider systems to small physician groups. Our advisory services offer a programmatic approach to addressing potential pitfalls throughout the midcycle, proactively preparing your health system to address revenue integrity risks.
  • Coding and CDI Technology: Optum360 Coding and CDI Technology can help you meet the ongoing demands for accurate documentation, coding, and reimbursement. Powered by industry-leading technology and algorithms honed over decades in the market, our coding and CDI solutions support peak performance and operational success. Our patented natural language processing (NLP) reads and understands clinical documentation to recognize key facts, assign codes, and identify potential gaps and quality events. Its automated, continuous review enables documentation improvement concurrent to care. The NLP engine powers the shared platform for Optum Enterprise Computer-Assisted Coding (CAC) and Optum CDI 3D. This integrated solution reviews 100% of your cases to support more complete and accurate documentation, coding, and reimbursement. Optum CAC Professional leverages NLP to enable consistent, compliant professional coding for optimal operations and accurate revenue capture. Its Coding Review Module verifies the accuracy of physician-assigned codes to support appropriate reimbursement. Optum Lynx Outpatient Charging Applications use proprietary algorithms and apply OPPS guidelines to facilitate consistent charge capture and code assignment. They offer comprehensive tools for emergency department, clinic, oncology, observation, and infusion services.

Current Time Inside Cache Tag Helper: 9/30/2020 3:28:58 PM and Model.VendorId = 61201

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Current Time Inside Cache Tag Helper: 9/30/2020 3:28:58 PM and Model.VendorId = 61201

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