[music playing]
Health plans are really trying to identify
examples of how AI can help them solve their business needs.
Ultimately, if you can find the root cause and the problem,
the innovation comes naturally.
I'm Bill Maly.
I work in our Payment Integrity business here at Optum.
The interesting thing about technology
and the value that we find
is when you can bring in both that health care expertise,
together with the advanced technology,
to build very powerful solutions.
Sometimes a standard rule or an edit will do the job.
But there are areas of payment integrity
where AI can add value,
and that's really around areas of driving operational efficiencies
and reducing provider abrasion.
Optum has been using AI in our solutions
for more than a decade.
Currently, we evaluate millions of claims per day
running through our AI algorithms and models.
Over those many years,
billions of claims have been evaluated,
and that has allowed us to improve
the accuracy of our detection,
detecting claims that, ultimately, edits and rules can't.
Another great opportunity for AI
is really in workflow prioritization.
So once we identify a claim that needs human review,
we prioritize that through our AI models
to route the claims to the most experienced reviewers.
So seeing what this technology is capable of,
and knowing some of the problems that our health plans are facing,
really gets me excited about what we can bring.
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