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
E-book
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.
Video
Fraud, waste and abuse in health care
Protect government programs with risk management solutions.
Resource
Automate fraud, waste and abuse
Speed up workflows for federal agencies through artificial intelligence (AI).
Resource
Utilize technology to harness disparate data
Invest in long-term fraud prevention.
Fresh insights
Resource
Visualizing fraud, waste and abuse
Graph analytics and machine learning drive the future of program integrity.
Infographic
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.
Sources
- Optum book of business as of Q1 2022.
- Optum. Machine Learning and Advanced Technology. August 2019. Accessed October 26, 2021.