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

Clean Claims, Insight into Denial Sources Spur Billing Efficiency for a Central California Hospital

Central California Hospital, a ~250‑bed facility with 300+ doctors and staff, was struggling with Medi‑Cal’s complex coding and modifier requirements, high manual adjustments, unclear denial sources, and limited visibility into billing efficiency. To address these challenges they turned to Optum, deploying RelayAssurance™ Plus and RelayAnalytics™ Acuity to manage claims and analyze revenue‑cycle trends.

Optum implemented RelayAssurance™ Plus to automate claim edits and add payer‑specific modifiers, and paired it with RelayAnalytics™ Acuity to surface denial trends by department and service line. The combined solution delivered daily claims visibility, reduced manual Medi‑Cal adjustments, lowered denial rates, and gave managers easy access to biller productivity data; the hospital reports cleaner Medicare claims (about 11% of aged Medicare claims at 90 days) and faster identification of root causes like registration and timely‑filing issues.

Central California Hospital