Optum Integrity One Flashcards
What is Optum Integrity One?
Optum Integrity One is an integrated medical coding and billing platform that unifies the middle of the healthcare revenue cycle. It’s a cloud-based solution combining computer-assisted coding (CAC), clinical documentation improvement (CDI), and charge capture tools into one system for healthcare providers. Its goal is to automate coding and documentation workflows so that hospitals and clinics can code patient encounters more efficiently and accurately.
What key features does Optum Integrity One offer?
Integrity One’s key features include advanced Computer-Assisted Coding for both professional (physician) and facility coding, an integrated CDI 3D module that uses AI (Optum’s Clinical Language Intelligence) to suggest accurate codes and improve documentation, and an outpatient charge capture system to ensure all billable services are recorded. These components are all housed in a single platform, enhanced by real-time analytics and automation, providing a seamless workflow from clinical documentation to final coding.
What are the benefits of using Optum Integrity One for healthcare organizations?
Organizations using Integrity One see improved coding accuracy and compliance, since automation and AI reduce human errors in coding. It increases efficiency by speeding up the coding process and lowering administrative costs – for example, reducing the time between patient discharge and final billing (DNFB) which leads to faster reimbursements. The platform also helps mitigate staffing challenges (fewer coders can handle more work with AI assistance) and provides a full view of each patient encounter, ensuring that documentation and billing are complete and correct. Overall, this leads to fewer claim denials, cost savings, and more focus on patient care rather than fixing billing issues.
In what use cases or settings is Optum Integrity One typically used?
Integrity One is used by hospitals, health systems, and medical groups to manage coding and documentation in their billing cycle. For example, a large hospital system will use it to standardize coding across all departments – helping coders code inpatient and outpatient records quickly and keep the discharged-not-final-billed counts low. Smaller clinics or physician practices might use it (directly or via a coding service) to ensure they code correctly without hiring full-time coders. Essentially, any healthcare provider that wants to improve billing accuracy and speed – from multi-hospital networks to solo practices – can use Integrity One to handle coding, documentation queries, and charge capture in a unified way.
What distinguishes Optum Integrity One from other revenue cycle solutions?
A key distinguishing feature of Integrity One is its all-in-one platform approach. It unifies what are often separate functions – coding, documentation improvement, and charge capture – into a single, end-to-end system . This comprehensive scope, combined with advanced AI and natural language processing, sets it apart. The platform leverages Optum’s Clinical Language Intelligence to read clinical notes and suggest codes in real time, providing smarter automation than basic coding software. Because it’s a single cloud-based solution, it ensures consistency and communication across coding and CDI teams, which improves accuracy and efficiency more than using piecemeal tools. In short, Integrity One offers a unified, AI-driven approach to revenue integrity that is hard to match with standalone products.
