The Optum® Enterprise Computer-Assisted Coding (CAC) and CDI 3D platform is an advanced, integrated solution designed for hospitals and large health systems. It leverages Optum’s patented Clinical Language Intelligence (CLI), also known as LifeCode® Natural Language Processing (NLP), a technology with over 20 years of proven performance that processes millions of clinical documents daily.
The platform automates and optimizes hospital coding and clinical documentation improvement (CDI) operations, providing a single, streamlined solution for coders, auditors, and CDI staff.
Key Capabilities and Modules:
- Automated Case Review: Provides comprehensive, continuous case review for all payers and achieves 100% concurrent automated record reviews.
- Intelligent Case Finding: The NLP engine looks deeper into supporting evidence (like lab results and vitals) to identify documentation weaknesses, potential quality events, and clinical validation opportunities, enabling CDI specialists to focus on high-priority cases.
- Accurate Code Assignment: Automatically assigns accurate diagnosis and procedure codes, applies robust coding edits, and supports ICD-10 and PCS code assignment.
- Integrated Workflow: Unifies CAC, CDI, and auditing on a single, shared platform with a seamless user interface, enhancing communication and collaboration.
- Audit and Compliance Manager: Identifies cases at risk for denial, enabling proactive pre-bill audits and preserving revenue integrity.
- LYNX Outpatient Infusion Charging: Uses a proprietary algorithm to correctly charge for infusion and injection services.
- Medical Reference Engine & Analytics: Includes a database of reference books and provides executive dashboards for tracking productivity and results.
Optum Enterprise CAC and CDI 3D is positioned as a comprehensive solution for revenue cycle management, helping organizations realize the benefits of greater coding efficiency and precision.