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FWA expertise and technology

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.

 

Our capabilities:

  • 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
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$30B

Optum Serve has saved or recovered $30B for 133 clients and 62 health plans.1

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25,000+

We have over 25K+ technologists, data scientists, actuaries and clinicians to help curb fraud, waste and abuse.2

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250M+

Optum maintains a database covering over 250 million deidentified lives of data used to foster innovation and research across health care.1

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With our combined capabilities we can manage any PI platform

We bring advanced IT services in cloud modernization, GitOps/DevSecOps, data management and robotic process automation.

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Fresh insights for federal agencies

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Protecting taxpayer dollars

Learn how Optum Serve has made a difference in mitigating risk and recovering money by detecting FWA.

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Commercial health care technologies for government agencies

Learn how to implement artificial intelligence for program integrity with federal agencies.

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Program integrity efficiency for federal agencies

Learn how we help clients establish an effective data strategy and analytic roadmap.

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Sources

  1. Optum book of business as of Q1 2022.
  2. Optum. Machine Learning and Advanced Technology. August 2019. Accessed October 26, 2021.