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Program Integrity Services

Our solution enhances and modernizes program integrity to combat fraud, waste and abuse by working to support the federal government.


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

FWA expertise and technology




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



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



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



Partnering to reduce, fraud, waste and abuse

Optum Serve helps federal agencies reduce fraud, waste and abuse through partnerships, technologies solutions and best practices. Download the ebook to see how we address challenges and support federal agencies unique needs.


Fraud, waste and abuse in health care

Protect government programs with risk management solutions.



Automate fraud, waste and abuse

Speed up workflows for federal agencies through artificial intelligence (AI).


Utilize technology to harness disparate data

Invest in long-term fraud prevention.


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.

Fresh insights


Visualizing fraud, waste and abuse

Graph analytics and machine learning drive the future of program integrity.


Deliver program integrity efficiencies

Curb fraud, waste and abuse for federal agencies.

White paper

Leveraging commercial health care technologies

Apply AI and program integrity practices in government.

Case study

Optum Serve: Protecting taxpayer dollars

Eliminate fraud, waste and abuse in health care spending.


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