Collections for Optum360 Clients

Optum360, a collaboration between Optum and Dignity Health (now CommonSpirit Health), is one of the largest revenue cycle management operations in healthcare. They manage billions of dollars in patient revenue for hospitals and health systems nationwide, providing technology-enabled RCM services that cover the full revenue cycle from scheduling and registration through final payment. Despite this comprehensive scope, there remains a critical need for dedicated collection services on accounts that don't resolve through standard RCM operations.

The Scale of Optum360's Operations

Optum360 processes revenue cycle functions for some of the largest health systems in the country. Their infrastructure handles millions of claims, manages complex payer relationships, and drives revenue integrity at scale. The sheer volume means that even a small percentage of accounts that fall through creates a substantial dollar amount in at-risk receivables. For a health system processing $2 billion in net patient revenue, a 3% fallout rate represents $60 million in accounts that need specialized collection attention.

Why Optum360 Clients Need MSB

Optum360's RCM model is built for efficiency at scale — processing high volumes of claims through standardized workflows. This works exceptionally well for the majority of accounts. But the accounts that don't fit standard workflows require a different approach:

• Individualized attention — Aged accounts often have unique circumstances (hardship, disputes, complex insurance situations) that require personalized handling by experienced collectors rather than automated workflows.
• Extended outreach persistence — Collection-level follow-up involves more frequent contact attempts, varied communication channels, and longer engagement timelines than standard RCM operations can sustain.
• Legal and regulatory tools — Credit reporting, settlement negotiations, and litigation are collection-agency functions that fall outside the scope of an RCM company.
• Skip tracing and advanced analytics — Locating patients and assessing collectability using databases and tools specific to the debt recovery industry.

Partnering at Enterprise Scale

Health systems that work with Optum360 are typically large, multi-facility organizations with complex governance structures. MSB has the operational maturity to serve these organizations effectively. We assign dedicated account management teams, implement facility-specific collection protocols, maintain compliance with each state's regulatory requirements, and deliver reporting at the granularity level that enterprise clients demand.

Our onboarding process for large health systems includes stakeholder alignment, data integration testing, compliance documentation, and a phased go-live that minimizes disruption to ongoing operations.

Measurable Impact on Net Revenue

Adding MSB as a collections partner has a direct, measurable impact on net patient revenue. Our clients see improvement in two key areas: recovered dollars from accounts that would otherwise be written off, and reduced bad debt expense as a percentage of net revenue. For health systems managing narrow operating margins, this improvement can be the difference between a surplus year and a deficit.