Claim Denial Appeal for Medical Coding Managers with Optum CAC
The Problem
CDI & Coding denials pile up in 3M 360 Encompass — each appeal takes 45 minutes of billing-team time and most die in the to-do pile because there aren't enough hours.
What We Build in Optum CAC
AI classifies denials by reason code, drafts the appeal letter with chart-cited clinical support, resubmits with corrected info, and tracks the payer response — appeal capture rate doubles. Purpose-built for teams running Optum CAC — uses the native API or agent integration so nothing leaves the system of record.
Optum CAC Integration Approach
Audit your Optum CAC configuration
We map the specific Optum CAC objects, custom fields, and workflows the automation needs to touch for your cdi & coding practice.
Build on the Optum CAC API or agent
Integration happens inside Optum CAC — no data leaves the system, no parallel tool for your team to learn, no license changes.
Human-in-the-loop handoff
Every automation routes exceptions back to a human in Optum CAC with enough context to act — AI handles the 80%, your team owns the judgment calls.
See this running in your Optum CAC instance
30-minute call. We'll look at your actual Optum CAC setup and show exactly how this workflow fits.