As health tech companies build out artificial intelligence to automate administrative tasks such as clinical documentation, they also see big opportunities to bridge the gap between the medical note and payment.
AI scribe Suki is collaborating with Optum Real, a real-time claims management system, to align clinical documentation and revenue cycle workflows in real time, executives at the two companies said at the Healthcare Information and Management Systems Society (HIMSS) 2026 Global Conference & Exhibition in Las Vegas last week.
Optum, part of UnitedHealth Group, unveiled the AI-powered system at the 2025 HLTH conference five months ago, highlighting the company's aim to remove the friction between providers and payers in claims processing and payment workflows.
The Optum Real platform leans on Al for both clinical and financial support at each step of the claims and reimbursement process, letting providers know in real time what's covered and ensuring payers receive more complete claims data that account for an individual's unique benefits, Fierce Healthcare reported in October.
Optum is piloting Real with its sister health insurer UnitedHealthcare on the payer side as well as with Allina Health, a health system operating 12 hospitals across Minnesota and Wisconsin, for outpatient radiology and cardiology claims. Allina has seen a reduction in administrative errors under the pilot as well as a better patient experience in the more than 5,000 visits processed so far, Optum executives said at HLTH.
Optum Real is teaming up with Suki to integrate its AI-enabled infrastructure with Suki's ambient clinical intelligence platform to support cleaner downstream billing processes, executives said. Suki's AI solution includes an AI ambient scribe as well as assisted revenue cycle and clinical reasoning capabilities. The company's technology can be used across 100 medical specialties and 81 different languages, and the company works with more than 400 health systems and other partners.
Nearly 15% of all claims submitted to private payers for reimbursement are initially denied, according to data from Premier. Health systems struggle with an inefficient network of disconnected systems for tasks like documentation, coding and claims, leading to delays and rework, noted Punit Soni, CEO of Suki, while speaking* on a panel at the HIMSS 2026 conference. These inefficient revenue cycle management workflows are driving up massive costs for the healthcare industry.
The end-to-end reimbursement flow in U.S. healthcare is broken, Puneet Maheshwari, senior vice president at Optum and general manager of Optum Real, said during the panel discussion. "The reason why it's broken is because there is a level of opacity between the payer and the provider. The nuance of decisioning is hidden in piles and piles of paperwork to manage the complexity of the submissions that are coming from the providers. Payers are investing heavily in processes on their side around integrity and together that's roughly $300 billion to $350 billion worth of administrative spend," he said.
Removing manual bottlenecks increases accuracy on the first submission and lowers the risk of denials tied to filing delays, Maheshwari and Soni said during the panel.
Clinical documentation is one modality to capture what's happening in a care encounter, Soni said. "The right logical next step has to be that then we extract all the financial information from it and remove this friction," he said.
The aim of the collaboration is faster, more accurate claims to reduce administrative waste, the executives said. AI can help reimagine processes and workflows, which could "bring down the cost of decisioning," Soni said.
Early results of the collaboration show faster documentation-to-billing cycles and fewer preventable issues, Soni and Maheshwari attest.
Heidi inks RCM partnership
R1 RCM, a competitor to Optum in the revenue cycle management space, also is ramping up partnerships to integrate into clinical workflows. Through its partnership with AI scribe Heidi, announced at HIMSS, the two companies will integrate Heidi's clinical documentation tech directly into R1’s revenue operating system, the companies said in a press release.
Heidi, which initially launched in Australia, says it supports more than 2.7 million consults each week in 110 languages from 190 countries. R1, through its revenue operating system, will translate this clinical intelligence into accurate and compliant claims, the companies said, to avoid denials, prevent defects and improve revenue recovery.
Heidi said its users will see greater visibility into payer policy information, prior authorization rules and insurance eligibility information at the point of care. Revenue cycle professionals will see higher-quality documentation entering billing workflows, with faster claim processing and improved reimbursement predictability, executives said.
"Revenue management companies have historically had limited integration with clinicians, while scribe companies have lacked system-level payer data. This important partnership changes that. By connecting R1's payer intelligence directly with Heidi’s platform at the point of care, we can deliver real-time billing and authorization guidance the moment it matters. Together we can close a gap that costs the whole system billions," Thomas Kelly, M.D., co-founder and CEO of Heidi, said in a statement.
Heidi also has been expanding its capabilities with the launch of Evidence, a clinical decision support tool that surfaces relevant research during the encounter. The company is moving into the same space as OpenEvidence, but Kelly says Heidi's business model is distinctly different as it's ad-free.
Heidi Evidence was built in partnership with HealthPathways, EMGuidance, MIMS, Vidal, NICE and the BMJ Group, among others, to ensure guidance reflects regional standards and formularies. The company says it's committed to noncommercial, auditable data, Kelly said.
Heidi Evidence is free for individual clinicians. The company says it uses enterprise revenue to subsidize access for practitioners in resource-constrained or fragmented markets.
It also developed Heidi Comms as a patient communication and scheduling tool. Kelly says Heidi is evolving from an AI scribe to an AI care partner to connect clinical documentation and real-time clinical reasoning. The aim is to expand clinical capacity by automating administrative work, he said.
“We see a transition from these scribes becoming more of an AI partner for many parts of the practice. The documentation is really valuable, but doctors make lots of clinical decisions, and it’s also about addressing capacity. The mission for the company is to try to increase healthcare capacity. The supply-demand mismatch so severe that, basically, if we're succeeding at Heidi, we should be trying to improve that curve in some way,” Kelly told Fierce Healthcare in an interview in February about the launch of Heidi's Evidence feature. “To do that you have to make the existing system more productive, but that only gets you so far. I think we see ourselves as ultimately having to get closer and closer to delivering care.”
Combining Heidi’s capabilities—scribe, Evidence and Comms—sets up the company to develop an AI-first primary care model, he noted.
“Let’s say, you want to see a doctor. You could first have a conversation with Heidi. Heidi can then look up the research, read the medical record and summarize what the doctor should be doing, and cite all of the different evidence that it's found about what's going on for you. That’s really powerful because it starts to spread out the supply issue. The doctor doesn't have to be the only one that can talk to you or the only one that can start to think about what to do for the case. Heidi can begin to do some of that work,” Kelly explained, noting that federally qualified health centers and value-based care providers have shown an interest in an AI-driven care model.
*The author moderated the Optum Real-Suki panel at HIMSS 2026.