Program Integrity Solutions

Optum Program Integrity solutions helped 22 state clients realize more than $300 million savings in 2012 alone.

Predict. Prevent. Protect. Transform.

Optum™ Program Integrity Solutions provide a comprehensive suite to detect, investigate, stop, or recover inappropriate, erroneous, and fraudulent payments and help contain costs. We provide solutions that span every step of the payment cycle, from prospective (pre-payment) to retrospective (post-payment) and evaluation solutions to continually refine and improve results along the way.

Our solutions provide:

  • Advanced detection and predictive analytics designed exclusively for Medicaid
  • Deep expertise in designing and using government payment and analytic systems
  • Low-risk, well-established processes and solutions with proven results
  • Comprehensive and flexible approaches: from services and software to business process outsourcing

Contact us to learn more about how we can help improve your program integrity operations.



Prepayment Solutions

Let Optum™ help you increase efficiency by paying it right the first time.

Post Payment Solutions

Our proven recovery solutions give states comprehensive options for identifying and recovering inappropriate payments.