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How Optum’s Claim Editing and Pricing Platforms Dominate the Industry
The DOJ tried to block a $13B healthcare deal because two companies together would have controlled ~95% of first-pass claims editing. Most people have never heard of that market. Here is why it matters. Optum had ~25% of claims editing. Change Healthcare's ClaimsXten had ~70%. Combined HHI was in the high 8,000s. The fix: UnitedHealth carved ...
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