Case Study: Pocono Medical Center protects revenue and improves coding accuracy with Optum

Fixing Unexpected Medical Coding Pattern Protects Revenue

Pocono Medical Center’s Employed Physician Network, the sole community hospital serving Monroe County, PA with 175 physicians across 27 specialties, faced high coder turnover and inconsistent physician coding that an external assessment found had produced significant miscoding over four years. Vice President Lamont Louis engaged Optum and its Coding and Compliance Advocate solution to address the compliance and revenue risk created by these coding discrepancies.

Optum implemented a three‑year coding and compliance initiative including a baseline assessment, a third‑party audit program with quarterly random-sample reviews, recurring physician training and certification, and education for internal coding leaders to sustain improvement. As a result, Optum helped Pocono Medical Center achieve continuous medical coding accuracy, reduce and mitigate compliance risk, and better protect revenue through standardized training, ongoing audits, and strengthened accountability.

Pocono Medical Center

Lamont Louis

Vice President Employed Physician Network