An autonomous-first platform for the revenue cycle

[NARRATOR] Healthcare organizations are under pressure, rising costs, tighter margins, and growing administrative complexity. In the middle revenue cycle, that pressure is amplified by fragmented systems and disconnected workflows, driving manual work and delayed decisions. With today's advances in AI, this work should be more accurate, efficient, and automated. That's why we built Optum Integrity One, an autonomous first platform designed to modernize the middle revenue cycle with precision, at scale. Integrity One brings autonomous coding to historically manual processes, capturing encounter details, helping address documentation complexity, and working to help close gaps before they become downstream denials. While others automate steps, Integrity One is designed to code at enterprise scale.

The result? Greater efficiency and accurate coding, helping to reduce costs, strengthen revenue integrity, and minimize denials. One large health system saw 180% in CDI financial impact, alongside a 50% boost in inpatient coding productivity. Because healthcare is complex, not every encounter can be handled the same way. For example, in the emergency department, many cases can be coded autonomously, but when clinical signals indicate greater complexity, Integrity One brings a human expert in the loop.

As documentation is created, the platform analyzes the patient record, applies coding logic in real time, and completes routine cases automatically. Here's how that comes to life. Janice arrives at the ED with chest pain and shortness of breath and is admitted for observation. As documentation is created, Integrity One automatically helps identify an opportunity, surfacing the likely presence, type, and acuity of heart failure based on provider documentation, clinical indicators, and treatment.

That insight is delivered directly to CDI within the platform, enabling a timely, focused provider query. With clarification in place, coding more accurately reflects Janice's clinical picture, supporting appropriate reimbursement and a more complete representation of care. Now, multiply that impact across all encounters. Our ED autonomous coding model can help deliver revenue uplift, improvements in coding efficiencies, and accelerated cash flow for the average health system.

When a human in the loop is needed, Integrity One can help to increase facility coding productivity, improve EM leveling performance, and facilitate CMI lift. This is the value of Integrity One, modernizing the middle revenue cycle through AI to automate the routine, escalate the complex, and help drive results at scale, all in one solution, from Optum.