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

Revenue Cycle Management Services Help Emergency Group Create Operational Infrastructure

PedEM, PLLC is a 16-physician pediatric emergency staffing group formed in 2012 to provide round‑the‑clock coverage for Baptist Children’s Hospital and manage roughly 30,000 cases a year. Faced with the urgent need to establish a viable billing and revenue cycle infrastructure — including claims and collections, physician enrollment, payer contracting, and financial projections — PedEM engaged Optum for turn‑key Revenue Management Services to get the practice operational and generating cash quickly.

Optum led pre‑launch planning and revenue projections, enrolled the group’s physicians with payers (including Medicaid), set up hospital data feeds and internal processes, and trained clinicians on documentation; ongoing coding, claims submission and denial management have been handled through Optum’s Emergency Medicine Center of Excellence. The go‑live proceeded smoothly, cash flow began quickly, and Optum’s detailed business‑intelligence reporting and documentation training produced measurable gains — immediate revenue improvements from better critical‑care time capture, validated scribe productivity benefits, long‑term revenue cycle stability, and ongoing process improvements.

PedEM

Fernando G. Mendoza

President