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Program integrity services

Get support for crucial federal government programs.

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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 use cases, including predictive analytics and integrating diverse data sets.

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$30B

saved or recovered for 133 clients and 62 health plans1

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25,000+

technologists, data scientists, actuaries and clinicians2

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260M

de-identified lives of data1

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Our capabilities:

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  • Policy analytics 
  • Prepay claims editing 
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  • Data analytics and visualization 
  • Payment integrity and recovery 
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  • Artificial intelligence and machine learning for FWA 
  • Benefit eligibility and provider screening automation
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Optum Serve also brings advanced IT services in cloud modernization,
GitOps/DevSecOps, data management and robotic process automation.

We can manage the underlying infrastructure, processes and governance of any program integrity platform.

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Fresh insights for federal agencies

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Article

Protecting taxpayer dollars

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

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Article

Commercial health care technologies for government agencies

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

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Find out how Optum Serve can help your organization to mitigate risk and recover money.

Request more information

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  1. Optum book of business as of Q2 2021
  2. Optum. Machine Learning and Advanced Technology. August 2019. Accessed October 26, 2021.
  3. Optum book of business as of Q2 2021