WEBVTT

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[music playing]

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Health plans
are really trying to identify

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examples of how AI can help them
solve their business needs.

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Ultimately, if you can find
the root cause and the problem,

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the innovation comes naturally.

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I'm Bill Maly.

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I work in our Payment Integrity
business here at Optum.

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The interesting thing
about technology

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and the value that we find

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is when you can bring in
both that health care expertise,

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together with
the advanced technology,

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to build very powerful solutions.

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Sometimes a standard rule
or an edit will do the job.

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But there are areas
of payment integrity

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where AI can add value,

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and that's really around areas of
driving operational efficiencies

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and reducing provider abrasion.

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Optum has been using AI
in our solutions

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for more than a decade.

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Currently, we evaluate
millions of claims per day

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running through
our AI algorithms and models.

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Over those many years,

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billions of claims
have been evaluated,

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and that has allowed us to improve

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the accuracy of our detection,

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detecting claims that, ultimately,
edits and rules can't.

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Another great opportunity for AI

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is really in workflow prioritization.

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So once we identify a claim
that needs human review,

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we prioritize that
through our AI models

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to route the claims to
the most experienced reviewers.

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So seeing what
this technology is capable of,

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and knowing some of the problems
that our health plans are facing,

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really gets me excited about
what we can bring.

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