[MUSIC PLAYING AND CONTINUING IN THE BACKGROUND THROUGHOUT THE VIDEO]
[Alexandra Povlishock walking through an Optum office]
[On-screen text: Simplifying processes for payers, providers, and patients]
ALEXANDRA POVLISHOCK: At Optum, I get to deliver and develop products that support payers and providers in their interoperability journey,
[Alexandra Povlishock working on a laptop]
removing friction and administrative burden from processes like prior authorization.
[Alexandra Povlishock speaking on screen]
I'm Alexandra Povlishock, and I'm a Senior Vice President of product with Optum.
[Alexandra Povlishock walking onto a studio sound stage and taking a seat]
The current prior authorization process is highly complex.
[On-screen text: Alexandra Povlishock, Senior VP, Product Optum]
For payers specifically, they are working a large volume of prior auth requests on a daily basis, coming with a significant amount of clinical documentation that their teams have to work through to make a decision on whether or not an authorization should be approved. For providers, the process is equally complex. Providers are working in multiple systems and have to collect documentation from a number of places in order to support their prior authorization submissions. To simplify that process, we are doing two things. We are seeking to leverage AI to ensure we're minimizing the back and forth between health plans and providers and helping both get to a faster decision for that patient's care. For providers, we are taking steps to reduce burden and eliminate extra work by connecting providers directly to coverage determination rules for a large number of health plans in their network. We are doing this to increase transparency into what is expected around prior authorization submissions, and we are leveraging tools that use AI to help support the clinical documentation gathering process. Our tools and our use of AI focus on achieving auto approvals where possible, never auto denials. And where an auto approval cannot be achieved, we rely on human in the loop workflows to support additional review before a final determination is made. Here at Optum, we will continue to work until we've made healthcare simpler for everyone. And for prior authorizations specifically, my team remains focused on building and deploying products that support payers, providers, and most importantly, patients.
[Animation, colored rings, with the words, “Always innovating” within it]
[On-screen text: AI solutions. Human decisions. Always innovating]
[On-screen text: Optum]
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