UnitedHealth AI System Cuts Medical Claims Denials

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UnitedHealth Group’s AI-powered system has significantly reduced medical claims denials at Allina Health, a hospital network based in Minneapolis. The AI system, known as Optum Real, flags claims that require additional documentation before submission, making the approval process faster and more accurate.

Allina Health’s Chief Digital Officer, Dave Ingham, noted that the UnitedHealth AI system eliminates the frustration of denied claims and reduces administrative workload. The Optum Real system was developed by UnitedHealth’s Optum Insight division and integrates with UnitedHealth’s insurance unit, UnitedHealthcare.

Sandeep Dadlani, CEO of Optum Insight, explained that the system aims to reduce transaction costs for insurance providers and add more organizations to its network. Instead of charging for basic functions, the company plans to generate revenue through digitization and premium services like advanced analytics.

UnitedHealth Group already uses over 1,000 AI applications across its operations, including its insurance and healthcare services. These technologies help with tasks such as transcription, data summarization, and claims processing, aiming to enhance operational efficiency.

In a previous earnings call, Dadlani shared that UnitedHealth’s digital initiatives had reduced call center traffic by 10%. According to a recent Google Cloud report, 44% of healthcare executives are already using AI agents, with many planning to increase their investment in AI technologies.

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