Clinical cost containment solutions
As a provider of pharmacy benefit management, Optum uses predictive analytics to help you reduce pharmacy and medical treatment costs on every claim. Our suite of clinical services includes:
- Medication analysis, which identifies medication-related concerns and develops a plan for cost containment.
- Clinical cost containment reviews, which apply expertise in settlement, pharmacy, medical services, equipment, and clinical management to systematically identify potential cost savings and support positive health outcomes.
- MSA clinical outreach, which collaborates with the treating physician to clarify future treatment needs and avoid outdated or vague treatment plans.
- Peer-to-peer reviews with the treating physician about appropriate therapeutic options and alternative treatment strategies, followed by Nurse Monitoring to track the progress of changes.
To refer a case for review, click on the appropriate box below.