Optum launches Optum Real to check claims with payers before submission
At HLTH 2025, Optum launched Optum Real, an AI-backed system that lets providers ask a payer in real time about a patient's benefits and whether a claim will be covered at the point of care, rather than weeks later during coding. The system uses AI to read payer contracts and policies. UnitedHealthcare is the first health plan on it, and Allina Health has been piloting it for outpatient radiology and cardiology claims, where it has processed more than 5,000 visits. Optum reported cuts in provider call volume of 25% to 42% and up to 75% fewer reimbursement submission errors in pilots.
Why it's notable: Claims denials and rework are a major cost for practices, and a payer-owned system that settles coverage questions up front could change how revenue cycle teams work, if payers beyond UnitedHealthcare adopt it.