Optum is building out it claims management platform Real with new provider-focused capabilities built in partnership with Microsoft.
By bringing together Optum's existing healthcare and AI experience with Microsoft's Azure, Dragon Copilot and Foundry platforms, the company said it is expanding Optum Real to allow providers to work more efficiently and spend more time with their patients.
The platform will be able to bring together key clinical and operational data that allows providers to have a full view across a patient's care and reimbursement process. Optum Real will also offer smarter coverage predictions that can ease the burden on coders and offer insights more quickly to clinicians.
In addition, the platform includes documentation and chart intelligence powered by AI, such as AI-supported tools to surface coverage and payment issues earlier in the prior authorization pipeline, which can avert delays and the need to escalate disputes.
“Providers are overwhelmed by disconnected systems and manual processes that take time away from patients,” said Kristie Richardson, chief product and services officer at Optum Insight, in a press release. “Optum Real, and our collaboration with Microsoft, is about solving these pain points at scale, bringing together deep subject matter expertise, trusted cloud and AI technology, and an ecosystem perspective to deliver real, measurable impact.”
Optum unveiled the platform last October at the HLTH Conference, where it said that the tool would be piloted with UnitedHealthcare, its sister company, as well as Minnesota health system Allina Health.
Other pilot programs have cropped up since then, and Optum has found that through Real, it's seen an 80% reduction in denials and 25% decrease in call volume.
The platform also eliminated as much as 75% of reimbursement errors, Optum said.
Owensboro Health, a health system in Western Kentucky, is one of the early pilot participants, and CFO Russ Ranallo said in the press release that the platform works to ease friction for providers.
“Innovation has always guided how we care for our community,” said Ranallo. “Modernizing our processes allows us to make the patient experience more seamless during the moments that matter most."