Optum B2B Case Studies & Customer Successes

Alma achieves simplified access to in‑network mental health providers with Optum Patient Access and Engagement

Alma

Aspire Health Plan achieves exemplary 0.54 CMS audit score with Optum mock-audit and consulting services

Aspire Health Plan

Melissa Hall

Director of Compliance

Anesthesia Group Achieves Strategic Growth Goals with Practice Management Services

Atlantic Anesthesia, P.C.

Amer Tabba

President

Atlantic Health System achieves regional health information exchange and improved care coordination with Optum

Atlantic Health System

Kevin Heglar

Manager Financial Systems, Patient Financial Services

Baystate Medical Center achieves a 79% reduction in late charges with Optum's structured cardiovascular reporting

Baystate Medical Center

Corey McKinstry

Manager

Bluegrass Orthopaedics achieves secure, disc-free telemedicine imaging with Optum (Stratus Imaging Share)

Bluegrass Orthopaedic

Andrew Carlson

Director of Business Development

Boca Raton Regional Hospital achieves 14% increase in point-of-service collections and higher patient satisfaction with Optum

Boca Raton Regional Hospital

Rudy Braccili

Executive Director, Revenue Cycle Services

Bronx-Lebanon Hospital Center achieves accelerated cash flow and reduced claim denials with Optum RelayAssurance Plus

Bronx-Lebanon Hospital Center

George Irizarry

Vice President, Revenue Cycle

Calvert Memorial Hospital reduces A/R days and increases upfront collections with Optum's AhiQa and Ahi Lobby

Calvert Memorial Hospital

Franklin Smith

Director of Patient Financial Services

Central California Hospital achieves streamlined Medi-Cal processing and reduced denials with Optum RelayAssurance Plus and RelayAnalytics Acuity

Central California Hospital

Cincinnati Fire Department achieves 40% EMS revenue gain with Optum

Cincinnati Fire Department

Adam Sedam

EMS Commander

Colonial Healthcare boosts clinical trial enrollment and diversity with Optum’s Clinical Trials Access Network

Colonial Healthcare

Christopher Mahr

Family Medicine

Community Health Systems achieves >99.5% clean claims and 25% reduction in accounts receivable days with Optum

Community Health Systems

Karen Schneider

Regional Director of Patient Financial Services

Covenant Administrators, LLC achieves 78%+ electronic payments, $260K annual VCC rebates and major cost savings with Optum's Settlement Advocate

Covenant Administrators, LLC

Theresa Walden

Specialty Program Director

Detroit Medical Center achieves reduced readmissions and higher patient satisfaction with Optum's RelayCare solution

Detroit Medical Center

Kathy Ingalls-Hefni

Corporate Director

Driscoll Health System achieves $14M annual operational savings and 15% higher claims auto-adjudication with Optum

Driscoll Health System

Mary Dale Peterson

Executive Vice President and Chief Operating Officer

Duke University School of Medicine accelerates COVID-19 research and uncovers care disparities with Optum's Data Science as a Service

Duke University School of Medicine

Michael Pencina

Vice Dean For Data Science and Information Technology

How a health system streamlined its provider patient scheduling and strengthened customer service to manage more than 65,000 patient calls monthly

Einstein Healthcare Network

Lamont Louis

Chief Operating Officer

Emergency Billing, LLC achieves faster reimbursements, under 2% claim denials and 24/7 client access with Optum Revenue Performance Advisor

Emergency Billing, LLC

Donna Gailey

Chief Executive Officer

Excel Medical Center achieves streamlined workflows and improved member care with Optum

Excel Medical Center

Theodore Burden

Chief Medical Officer

Fallon Health achieves 75% faster MDx prior-authorization decisions with Optum’s DEX™ Diagnostics Exchange

Fallon Health

Pamela Cardaci

Senior Director of Utilization Management and Prior Authorization

Florida Hospital Orlando achieves 200+ avoided inappropriate ED admissions and nearly $500K in savings with Optum InterQual

Florida Hospital Orlando

Eugene Truchelut

Medical Director

Global Regional HealthCare Service Provider achieves streamlined payment integrity and unified reporting with Optum

Global Regional HealthCare Service Provider

Good Samaritan Health System achieves faster payments and 90%+ claim acceptance with Optum RelayAssurance Plus

Good Samaritan Health System

Cynthia Schwalm

Patient Accounting Manager

Goshen Health achieves reduced uncompensated care and improved patient satisfaction with Optum Eligibility and Enrollment Services

Goshen Health

Grand View Health achieves rapid COVID-19 nurse triage and schedules 17,000+ vaccinations with Optum (Change Healthcare)

Grand View Health

Heidi Aubertin

Quality Improvement Lead for Medical Practices

Gwinnett Medical Center achieves a 62% increase in collections and $600K+ monthly online payments with Optum

Gwinnett Medical Center

James Barwick

Pre-Authorization Manager

Halifax Health converts $69.8M in self-pay and reduces uncompensated care with Optum Financial Clearance Services

Halifax Health

Arvin Lewis

Chief Revenue Officer

Halifax Health reduces uncompensated care and increases patient enrollment with Optum Eligibility & Enrollment Services

Halifax Health

Steve Mach

Director of Patient Financial Services

Halifax Health achieves 99% registration accuracy and faster real-time eligibility verification with Optum’s Clearance Patient Access Suite and Ahi QA™

Halifax Health

Angela Bolte

Patient Access Manager

Health First normalizes bad-debt-to-charity ratio and boosts point-of-service collections with Optum's RelayClearance

Health First

Michelle Fox

Director of Patient Access Revenue Operations

Health First achieves 45% increase in up-front collections and 18% reduction in A/R days with Optum (Clearance Patient Access Suite & Ahi QA)

Health First

HealthEdge achieves rapid MA-PD launch and 100% claims processing accuracy with Optum

HealthEdge

HealthFocus achieves secure, scalable foster-care services with Optum

HealthFocus

HIPAA-regulated residential services organization achieves audit-ready compliance with Optum

HIPAA

Large HealthCare Plan achieves consistent member communications and cost and time savings with Optum

Large HealthCare Plan

Large Medicaid Health Plan increases risk score and achieves 7:1 ROI with Optum

Large Medicaid Health Plan

Large Medicaid Planning Company achieves 29% increase in chart collection and improved HEDIS measure rates with Optum

Large Medicaid Planning Company

Large Midwest Medical Center secures $934M in Medicaid coverage and streamlines eligibility with Optum Eligibility and Enrollment Services

Large Medical Center

Large National Payer Company wins state Medicaid contract and builds comprehensive statewide provider network with Optum

Large National Payer Company

Large Southeast-Based Healthcare Company recovers retroactive ESRD payments and boosts payment integrity with Optum

Large Southeast-Based Healthcare Company

Leading Behavioral Health Service Provider achieves behavioral health insourcing and improved care integration with Optum

Leading Behavioral Health Service Provider

Leading Healthcare Company achieves SOC II Type II readiness with Optum

Leading Healthcare Company

Aspire Health Plan (Leading Healthcare Consulting Service Provider) achieves an exemplary 0.54 CMS audit score with Optum

Leading Healthcare Consulting Service Provider

Leading Healthcare Consulting Service Provider - Customer Case Study

Leading Healthcare Consulting Service Provider

Leading Healthcare Service Provider achieves CAQH CORE certification and launches Medicaid benefit with Optum

Leading Healthcare Service Provider

Leading Insourcing Medicaid Company achieves seamless insourcing of Medicaid operations with Optum

Leading Insourcing Medicaid Company

Leading Private Not-for-Profit Hospital achieves $1M recovery in 45 days and ~$8M annual revenue with Optum (2% net revenue improvement)

Leading Private Not-for-Profit Hospital

Leading Small Managed-Care Health Plan achieves CAQH CORE certification, avoids $1.5M/year penalties, and launches Medicaid coordinated-care benefit with Optum

Leading Small Managed-Care Health Plan

Major National Health Plan drives paper-to-electronic migration to 88.5% electronic payments and $6.2M annual savings with Optum Settlement Advocate

Major National Health Plan

Mankato Clinic achieves reduced claim denials and faster reimbursements with Optum's RelayAssurance Practice

Mankato Clinic

Debra Addis

Director of Revenue Management

How a fully managed cloud-native PACS transformed a rural hospital

McKenzie Memorial Hospital

Jay Smith

Director of Diagnostic and Cardiopulmonary Imaging

Meridian Laboratory Physicians achieves 15–20% increase in collections and sustained financial stability with Optum Revenue Cycle Management

Meridian Laboratory Physicians

Anis Rangwala

Managing Director & President

Methodist Hospitals achieves a 3% call abandonment rate and $1.4M+ monthly online collections with Optum

Methodist Hospitals

Lisa Schillaci

Patient Accounting

Metro Health Hospital achieves fewer claim rejections and improved A/R with Optum's Assurance Reimbursement Management™

Metro Health

Kevin Rosenau

IT supervisor of Business and Revenue Cycle

Munson Healthcare achieves $1M+ in additional upfront collections and streamlined billing with Optum's RelayClearance Plus

Munson Healthcare

Kari Smith

Educator/ Coordinator For Patient Financial Services

Nanticoke Health Services achieves $1M cash flow boost and faster revenue cycle with Optum

Nanticoke Health Services

Linda Morris

Director

North Mississippi Medical Center achieves faster report turnaround and 100% pediatric/fetal echo adoption with Optum's Change Healthcare Cardiology

North Mississippi Medical Center

Carla Durham

Nurse Manager

Northeastern healthcare system achieves reduced costs and improved clinical and operational outcomes with Optum

Northeastern healthcare system

Orlando Anesthesia Consultants achieves improved efficiency, financial stability and greater profitability with Optum Physician Group Management Services

Orlando Anesthesia Consultants

Mark Addonizio

Managing Director

Orlando Health reduces A/R days and gains insight into denials with Optum's RelayAnalytics Acuity

Orlando Health

Cyndra B. Alderman

MSHA, Billing And Governmental Department Manager For Patient Accounting

PedEM achieves a rapid practice launch and long-term revenue cycle stability with Optum Revenue Cycle Management

PedEM

Fernando G. Mendoza

President

Pocono Medical Center protects revenue and improves coding accuracy with Optum

Pocono Medical Center

Lamont Louis

Vice President Employed Physician Network

ProHealth Physicians ACO, LLC achieves rapid D-SNP insourcing and full operational readiness with Optum

ProHealth Physicians ACO, LLC

Radiology Associates of Nevada achieves 47% reduction in bad debt and increased cash flow with Optum Revenue Cycle Management Services

Radiology Associates of Nevada

Darren Blanford

Practice Administrator

Revenue Cycle Management Services Improves Collections, Strengthens, Compliance and Enhances Reporting

Radiology Associates of Wichita Falls

Klonie Berend

President

Regional commercial health insurer achieves $4.66 PMPY savings and >250% ROI with Optum Coordination of Benefits solutions

Regional Commercial Health Insurance

Regional Health Plan achieves $357,000 annualized HCC gain with Optum's AI-driven MA chart recoding and reprocessing

Regional Health Plan

Regional health system in the Northeast achieves 99% scheduling accuracy and 98% call quality with Optum Patient Access Contact Center Services

Regional Health System

Regional One Health reduces observation rate and boosts utilization review efficiency with Optum Case Advisor

Regional One Health

Sandra McClairen

Director of Inpatient Access Services

Resurrection Health Care achieves $32M in correlated incremental revenue with Optum RelayCare Revenue Tracker

Resurrection Health Care

Cheryl Dusenbery

Call Center Director

Roper Radiologists PA achieves faster ED and ICU turnaround, 56% fewer delayed ED cases and 600 hours/year saved with Optum (Change Healthcare Workflow Intelligence)

Roper Radiologists PA

Matthew Brady

Managing Director Diagnostic Radiologist

Dramatically Increase Patient Collections and Reduce Days in A/R

Saint Clare’s LLC

Rohan Somar

President and Chief Executive Officer

Saint Luke’s Health System achieves accurate upfront estimates, improved patient financial experience and a 26% increase in point-of-service collections with Optum (RelayHealth)

Saint Luke’s Health System

Paul Knudtson

Director of Patient Access

Saint Luke’s Health System Taps the Power of Analytics to Help Boost Clean Claim Rates, Reduce Rejections

Saint Luke’s Health System

Elda Dykes

Manager of Patient Accounts

Salem Health Improves Accessibility to EMR Data

Salem Health

Kevin Thompson

Cardiologist

The Digital Transformation Journey to Improve the Patient Experience

Saltzer Medical Group

Julie Allen

Executive Director

Scripps Health achieves improved patient satisfaction and increased collections with Optum

Scripps Health

Dan Kehl

Director of Patient Financial Services

Silverton Hospital achieves faster claims submission and reduced A/R days with Optum's RelayAnalytics Pulse

Silverton Hospital

Sean Riesterer

Director of Revenue Cycle

Singing River Health System achieves a smooth billing-system transition and day-one full functionality with Optum Revenue Cycle Management Services

Singing River Health System

Mark LaFontaine

Director of Revenue Integrity

Sky Lakes Medical Center achieves a 25-day reduction in A/R and a 4% net revenue increase with Optum

Sky Lakes Medical Center

Andrew Molatore

Director Of Patient Financial Services

Southeastern Medical Group achieves improved patient experience and administrative efficiency with Optum

Southeastern Medical Group

Southeastern Medical Group achieves efficient EHR selection and improved clinical workflows with Optum

Southeastern Medical Group

Spartanburg Regional Healthcare System achieves improved revenue-cycle insight and higher first-pass claim rates with Optum's RelayAnalytics Pulse

Spartanburg Regional Healthcare System

Brian Earnest

Vice President of Revenue Cycle

St. Luke’s Health System achieves 8,000+ new patient bookings and 287% booking growth with Optum Digital Scheduling (Optum)

St. Luke’s Health System

Stamford Pathology Group achieves restored reimbursements and reduced accounts receivable with Optum Revenue Cycle Management Services

Stamford Pathology Group

Robert C. Babkowski

President

State Department of Health (state health service provider) empowers residents to make informed health plan choices and reduce costs with Optum's Health Plan Ratings Dashboard

State Department of Health Service Provider

State’s Health and Medicaid Department achieves earlier pregnancy identification and reduced infant mortality with Optum EDW

State’s Health and Medicaid Department

Tampa General Hospital validates end-to-end ICD-10 readiness with Optum’s RelayAssurance Plus

Tampa General Hospital

Gale Scott

EDI Regulatory Compliance Administrator

The Bellevue Hospital achieves 99.5% registration accuracy and reduced wait times with Optum's AhiQa and Ahi Lobby

The Bellevue Hospital

Nicholas Courtright

Patient Access Manager

The Midwestern achieves rapid cybersecurity readiness and a NIST-based security roadmap with Optum

The Midwestern

The National Committee for Quality Assurance achieves NCQA Health Plan Accreditation readiness with Optum

The National Committee for Quality Assurance

Trizetto achieves enterprise modernization and streamlined claims processing with Optum

Trizetto

Trizetto achieves modernized core administration and streamlined operations with Optum

Trizetto

UCare achieves 30% cost savings and improved provider satisfaction with Optum's EDI pre-adjudication solution

UCare

Rose Marie Tetzlaf

Director of Claims Operations

United Health Services achieves 99% A/R resolution and a seamless billing-system transition with Optum

United Health Services

Tami Miller

Manager of Access Care

University Health Care System reduces readmissions and automates telemonitoring with Optum RelayCare

University Health Care System

Julie Bell

Manager

University-Sponsored Payer achieves real-time predictive Medicare STARS insights with Optum

University-Sponsored Payer

Vancouver Coastal Health achieves reduced length of stay and optimized staffing with Optum's Capacity Planner

Vancouver Coastal Health

Mark Chase

Executive Director of Decision Support

VITAS Innovative Hospice Care achieves 35‑day A/R and fewer denials with Optum (RelayAssurance)

VITAS Innovative Hospice Care

Bert Tracey

Vice President and Chief Accounting Officer

Wallace Thomson Hospital achieves streamlined claims management and recovered reimbursements with Optum (RelayAssurance & RelayClearance)

Wallace Thomson Hospital

Roger Miller

Director of Revenue Cycle

Western Maryland Health System reduces denials and lowers average daily census with Optum InterQual criteria

Western Maryland Health System

Barry P. Ronan

President and Chief Executive Officer

Winchester Emergency Physicians achieves streamlined accounting and regains 10 hours/week with Optum Physician Group Management Services

Winchester Emergency Physicians

David Watts

M.D., Emergency Medicine Physician

Zing Health achieves rapid Medicare Advantage launch and 99% of claims paid within 30 days with Optum

Zing Health

Garfield S. Collins,

COO and co-founder

Optum B2B Case Studies & Customer Successes

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