As healthcare providers see patient reimbursement dip and funding trickle, a provider's ability to submit and collect on insurance claims on the first try is vital to hospital cash-flow.
By sharing and combining technology solutions, Optum and Availity hope to streamline the claims submission process and mitigate claims errors for providers, health plans and patients.
Under the agreement, Availity will implement Optum's claim editing software within Availity's real-time health information network.
The software collaboration will enable participating health plans to quickly notify providers of data errors or information gaps that will trigger claim denials, thereby allowing a provider to adjust errors in real-time. A more accurate and timely claims process would, in turn, better prepare patients for their financial responsibility, the companies note.
"Availity offers a single point of engagement for health plans and care providers, which leads to improved payment turnaround and more accurate claims submissions," said Availity CEO Russ Thomas. "We are delighted to have been selected by Optum to connect its industry-leading advanced claims editor solution to our broad national network of health plans."
In addition to the partnership, Optum plans to move $1 billion in business transactions to Availity's network.