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Operations and technology

Optum Real

Improve transparency and administrative efficiency through real-time payer-provider connection.

A healthcare payment system that works better for everyone

Healthcare claim processing is complex, time-consuming and often frustrating. Payers and providers must navigate legacy technology, complex rules and unclear regulations, and a lack of effective interoperability between payer and provider systems. These challenges lead to significant inefficiencies like unnecessary denials, lack of transparency, untimely delays and abrasion between payers, providers and patients.

Both payers and providers end up spending unnecessary time and money on administrative tasks and rework instead of focusing on patients and their care. Powered by AI and automation, Optum Real is facilitating real-time interoperability between payers and providers to help make the health system work better for everyone.

Transforming claim processing

With real-time exchange of patient visit, claim and payment data between payers and providers, Optum Real gives providers insight into how payers will process a claim when they need it — from pre-service to payment.

It also leverages ambient AI to capture the patient-provider encounter and autogenerate notes directly in the provider’s existing workflow. Our Clinical Language Intelligence engine uses AI to identify gaps and provide intelligent recommendations, helping reduce provider burnout, minimize administrative costs and improve documentation and coding accuracy.

Key benefits

A smarter, faster way to connect payers and providers

Real-time connection in the provider workflow can help create a healthcare payment system that works better for everyone.

Reduce claim denials

With real-time transparency into payer criteria, we give providers the insight they need to accurately code and bill claims upfront, reducing unnecessary rework.

Reduce administrative costs

We help streamline routine tasks like eligibility and authorization checks, reducing administrative work and costs for both payers and providers.

Enhance the patient experience

Patients get clear answers about what’s covered and what they’ll owe before they receive care, helping improve price transparency and satisfaction.

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Start working toward a more seamless healthcare system with Optum

Transforming claim processing

With real-time exchange of patient visit, claim and payment data between payers and providers, Optum Real gives providers insight into how payers will process a claim when they need it — from pre-service to payment.

It also leverages ambient AI to capture the patient-provider encounter and autogenerate notes directly in the provider’s existing workflow. Our Clinical Language Intelligence engine uses AI to identify gaps and provide intelligent recommendations, helping reduce provider burnout, minimize administrative costs and improve documentation and coding accuracy.