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NARRATOR: Across health care,

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fraud schemes move fast,

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exploiting gaps, shifting tactics,

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and outpacing traditional controls.

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By the time fraud is detected,
it's often too late.

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Optum is changing that.

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We're moving
fraud detection upstream,

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stopping suspicious activity
before claims are paid.

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What makes this possible
is our unique vantage point.

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We can see across payers,

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across providers,

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across the healthcare system.

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Our suite of products
connects data at scale

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and applies advanced analytics, AI,

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and decades of experience
fighting fraud to reveal patterns

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that may not be visible to
an individual payer

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acting on their own.

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Together, they assess provider risk,

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surface emerging threats,

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and enable decisive action.

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Every year, tens of thousands
of new providers enter the system

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Many are legitimate.

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Some are not.

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Our enhanced
provider verification technology

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technology evaluates
provider integrity and risk

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the moment they attempt to enroll.

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We instantly map each provider
into a network of identities,

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relationships,
and historical behavior,

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enabling payers to verify
whether the provider exists

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and whether they should be trusted.

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If risk is detected, claims are held

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and an investigation begins,

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stopping hit-and-run fraud before
a single dollar leaves the system.

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And because
provider status can change,

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we proactively reassess integrity
after enrollment,

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monitoring for changes to the risk
a provider poses.

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Our advanced AI models

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continuously analyze
provider behavior,

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uncover hidden connections
across vast data sets,

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and identify anomalies
which may signal emerging schemes.

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Investigative tools map how
entities and transactions interlink,

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making even
sophisticated schemes visible.

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When suspicious patterns appear,

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immediate alerts are triggered,

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empowering payers to act
before losses mount.

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Optum is making this possible,

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innovating at the speed and scale

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modern health care demands.

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