Optum Pay Makes Changes Based on Social Work Feedback

Optum Pay launched a premium version of its payment management system several months ago, which charged providers a 0.5 percent fee to receive a detailed explanation of benefits. After receiving national complaints from clinical social workers and chapters, Optum has now included many of the premium features in its free basic version.

NASW has issued a practice alert to address this change, Attention Clinical Social Workers: Optum Pay Update.

The document, written by Denise Johnson, senior practice associate at NASW, discusses the features of the premium and basic version. It also informs providers on how to access payment and claims information for free through Optum’s Provider Express Portal.

Johnson points out that in January, Optum Pay — a platform of UnitedHealthcare — launched an upgraded version of its payment management system, Optum Pay premium. The premium version is a paid option that offers several new features to help providers manage electronic claim payments.

These Include:

  • Access to up to 36 months of payment and remittance search history
  • Enhanced search options
  • Capability to sort claims according to reconciliation status
  • Ability to track the number of claims consolidated into each payment

The rollout was met with numerous complaints from clinical social workers and other providers, particularly as it related to paying a 0.5 percent per claim fee to access remittance data, elimination of the option for paper checks, and limited functionality of its Optum Basic platform which is free, the alert notes.

In response to this feedback, Optum expanded the features of Optum Pay basic. Most notably, CSWs will now have access to up to 13 months of payment data, which they will be able to download onto 813 and PDF files as well as other features.