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What is Optum360?

Optum360 delivers specialized physician advisory services, integrates evidence-based medical research, and employs cutting-edge artificial intelligence (AI) technology to optimize reimbursement practices and ensure accurate documentation. Our team works alongside your medical staff to pinpoint improvement opportunities. You have the flexibility to choose from our extensive range of services or technology, or even a combination of both, tailored to your unique needs. We offer both on-site and remote services that harness AI for efficient patient status evaluations. Our goal is to improve the efficiency, precision, and reliability of your utilization review processes and outcomes. With our Physician Advisor Services and Case Advisorâ„¢ technology, we help reduce denial rates, boost appropriate reimbursement, and mitigate the risk of audits. Additionally, our technology enhances the productivity and effectiveness of your internal physician advisors, enabling them to perform at their best. By merging these resources, we strive to create a cohesive experience that ultimately enhances patient care, streamlines administrative workflows, and fosters collaboration among healthcare professionals.

What is Amy by CombineHealth?

Developed by CombineHealth, Amy is a cutting-edge AI solution that automates medical coding processes and is specifically designed for mid-sized hospitals and multi-specialty physician practices, allowing them to optimize complex coding workflows with confidence. It supports a wide array of coding systems, including CPT, ICD-10, HCPCS, E/M, modifiers, and various requirements unique to different specialties. By meticulously analyzing clinical documentation in conjunction with coding guidelines, payer regulations, and specialty standards, Amy generates accurate and clear coding suggestions. The system is adept at identifying missed services, recognizing documentation gaps, highlighting instances of undercoding, and detailing coding exceptions, all while providing the necessary evidence to support each recommended code. A remarkable feature of Amy is its continuous feedback mechanism; while coding each chart, it evaluates the outcomes related to claims, such as denials and responses from payers, which helps refine its coding precision and reduce the likelihood of recurring errors. In real-world scenarios, Amy demonstrates an impressive coding accuracy rate that surpasses 98%, achieves automation levels of up to 85% in the coding workflow, and contributes to an impressive 75% reduction in coding-related denials. This unique blend of automation and accuracy positions Amy as an essential resource for healthcare providers seeking to enhance their coding efficiency and reliability, ultimately fostering improved patient care and operational success.

Media

Media

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Integrations Supported

Avalon Laboratory System

Integrations Supported

CombineHealth AI

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

Pricing not provided

Supported Platforms

Not specified

Supported Platforms

SaaS

Customer Service / Support

Not specified

Customer Service / Support

Not specified

Training Options

Not specified

Training Options

Not specified

Company Facts

Organization Name

Optum

Company Location

United States

Company Website

www.optum360.com/solutions/coding-and-documentation/physician-advisor-solutions.html

Company Facts

Organization Name

CombineHealth

Date Founded

2022

Company Location

United States

Company Website

www.combinehealth.ai/

Categories and Features

Electronic Medical Records (EMR)

Compliance Tracking
Self Service Portal

Categories and Features

Medical Coding

Not specified

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