For more than 20 years, Optum Serve® has partnered with federal health customers to mitigate fraud, waste and abuse (FWA) and improper payments. We combine IT capabilities with commercial, private and state FWA experience.
We partner to establish a modernized, ﬂexible framework for risk management. This includes advanced tools like artiﬁcial intelligence and machine learning, based on best practices we’ve established in our commercial health care division.
We also establish customer-speciﬁc frameworks for tailored program integrity (PI) use cases, including predictive analytics and integrating diverse data sets.
- Policy analytics
- Prepay claims editing
- Data analytics and visualization
- Payment integrity and recovery
- Artificial intelligence and machine learning for FWA
- Benefit eligibility and provider screening automation