HEDIS / Quality Measure Tracking for Medical Coding Managers with Optum CAC
Run hedis / quality measure tracking on autopilot inside Optum CAC.
The Problem
Value-based contracts tie revenue to HEDIS measures, but most CDI & Coding practices only realize they're off-target at year-end when it's too late to fix.
What We Build in Optum CAC
AI tracks every measure gap in real time from 3M 360 Encompass, schedules outreach for overdue patients, and reports attainment monthly — practices hit bonus thresholds instead of missing them. 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.
Frequently asked
Does this hedis / quality measure tracking automation work natively in Optum CAC?+
Yes — we build directly on Optum CAC's API or agent integration. Your data stays in Optum CAC, your medical coding managers keep the same login and UI, and there's no parallel system for the team to learn.
What Optum CAC configuration do we need before deployment?+
We work with your existing Optum CAC setup. During discovery we map the specific objects, custom fields, and workflows the automation touches — no rip-and-replace required for cdi & coding teams.
Can Optum CAC handle hedis / quality measure tracking on its own?+
Optum CAC handles configuration; AI handles judgment. Native Optum CAC workflows route deterministic tasks; our automation layer adds the AI judgment Optum CAC doesn't ship out of the box — document classification, exception triage, drafting.
Is Optum CAC the right tool for hedis / quality measure tracking for medical coding managers?+
Optum CAC is widely used among cdi & coding teams precisely because of its data model around hedis / quality measure tracking. We've deployed this workflow on Optum CAC for similar firms and the integration is well-trodden.
What's the typical ROI of hedis / quality measure tracking automation in Optum CAC?+
For cdi & coding firms running Optum CAC, automation typically pays back inside the first quarter — measured against the loaded cost of the medical coding manager hours absorbed. Higher volumes deploy faster.
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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.