Insightful solutions 

At ​Optum, we have a passion for doing what's right, for our clients, the injured person, and the industry. That is why we are always looking for brighter solutions to meet the challenges in the workers' compensation and auto no-fault industries. This passion inspires us to reshape the way things are done into the way things should be done. And, of course, to never stop working toward even better solutions.

  • Pharmacy benefit managementOur vibrant pharmacy benefit management program provides innovative cost-saving solutions that move beyond the traditional per-transaction approach of savings from a single prescription. We factor in the overall cost savings that comes from not filling unnecessary prescriptions, clinical improvements that return an injured person to activity sooner, and faster claims processing with minimized paperwork. This encompassing approach stems from our innovative combination of proprietary network capture capabilities, veteran clinical expertise, patent-pending advanced analytics, and time-tested operational expertise.

  • Ancillary benefit management - Our comprehensive ​ancillary services are easily navigated and provide a vast network of carefully-vetted, quality providers offering durable medical equipment (DME), home health care, transportation, translation services, and outpatient care.
  • Managed care services - Gain access to our PPO network service, medical bill review and case management to provide quality care that improves clinical and financial outcomes.
  • Settlement solutionsAt Optum, we provide solutions from first fill through settlement. Our settlement solutions identify and mitigate potential barriers to a CMS-compliant (Centers for Medicaid and Medicare Services) settlement. We shed light on the complexities of Medicare set-asides and provide reporting and clinical tools that pave the way to claim resolution.

Workers’ ​compensation

Whether you are an insurance carrier, third party administrator, governmental entity, or self-insured employer, we are lighting the way forward from first fill to settlement with enhanced services, accessibility, clinical insights, and patent-pending predictive analytics. Click one of the icons below to learn how doing what's right means making sure the right decisions are made at the right time.

 

Auto No-Fault

Customized pharmacy and ancillary services for the auto no-fault industry. ​​​These comprehensive solutions provide the tools for better decision-making through quality networks, advanced analytics, and clinical expertise that promote policyholder satisfaction and retention.


Federal ​services

Drawing on nearly 40 years of experience serving government agencies, ​Optum has created a comprehensive workers’ compensation program to address federal agencies’ most critical needs for managing pharmacy benefit and ancillary services.