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

Claims Billing Made Easier Through Integration of Disparate Systems

Metro Health Hospital (Wyoming, MI), a 208‑bed system with more than 2,400 employees and 78 employed physicians, needed a claims management solution that would work with Epic while giving its billing team more control over claim filing. To address this, Metro Health implemented Optum’s Assurance Reimbursement Management™ to replace the ambulatory product and retain front‑end claim review and editing capabilities.

Optum integrated Assurance with Epic in a low‑maintenance way that lets billers see and correct claims before submission, use historical claim data and Medicare Direct Entry checks, and apply payer‑specific formatting rules. As a result, Optum’s solution lowered initial claim rejections, sped reimbursements, improved days in A/R, and created more transparent, controllable processes that reduced denials and boosted revenue cycle efficiency.

Metro Health

Kevin Rosenau

IT supervisor of Business and Revenue Cycle