Optum Healthcare Termination Letters for RCM Services (Med Practice Made Perfect Ep. 08)

Welcome to MedPractice Made Perfect, brought to you by Practicefirst Medical Management Solutions. In this episode, host Tom Maher will delve into a pressing issue affecting many medical practices: termination letters for RCM services from Optum.

Understanding the Situation

Optum recently acquired a significant portion of business from ChangeHealthcare. As part of the integration process, Optum has begun terminating contracts with practices having fewer than 16 providers. These termination notices typically provide a 90-day window for practices to find alternative solutions.

Considering Insourcing vs. Outsourcing

Some practices may consider insourcing their revenue cycle management (RCM) processes as an alternative to outsourcing. However, there are crucial factors to consider. Assessing the size of your practice and the availability of qualified staff is essential. In today's market, there's a shortage of experienced billers, making it challenging to maintain an in-house RCM team, especially for smaller practices.

Transitioning to New Platforms

Many affected practices are using the Medent platform, tied to Optum's license. Transitioning to a new Medent license, particularly the cloud-based option, may be necessary. While this transition might come with additional costs, it offers advantages such as enhanced security, centralized claims processing, and access to advanced tools.

Other Considerations

It's important to note that Optum is not the only entity divesting smaller clients. Other providers may face similar situations in the future. For practices seeking support during this transition, companies like Practicefirst offer comprehensive RCM solutions backed by decades of experience.

Support from Practicefirst

Practicefirst, with 64 years of service in the New York area and a presence in multiple states, specializes in billing, coding, and credentialing across various specialties and carriers. While we have a minimum fee for billing services, we cater to practices of varying sizes and offer flexible solutions tailored to individual needs.

Conclusion

If you find yourself grappling with an Optum termination letter for RCM services or similar challenges, don't hesitate to reach out to Practicefirst. We can provide guidance and support to ensure a smooth transition and uninterrupted revenue flow for your practice.

Practicefirst is an industry leader in revenue cycle management, providing medical billing, coding, credentialing, and full-service practice management solutions to healthcare organizations.