Optum Unveils AI Platform to Streamline Claims Processing

The platform leverages AI for both clinical and financial support across each stage of the claims and reimbursement process.

Optum has introduced Optum Real, a new artificial intelligence-powered claims processing platform designed to enhance efficiency and transparency in healthcare billing. The launch was announced at the 2025 HLTH conference.

The platform leverages AI for both clinical and financial support across each stage of the claims and reimbursement process. It provides real-time insights on coverage for providers and ensures more complete claims data for payers.

Optum is currently piloting Optum Real with its sister insurer, UnitedHealthcare, and Allina Health, which operates 12 hospitals across Minnesota and Wisconsin. The pilot, focusing on outpatient radiology and cardiology claims, has processed over 5,000 visits to date. According to Allina, the initiative has reduced administrative errors and improved the overall patient experience.

Dave Ingham, Chief Information Officer at Allina Health, said the platform addresses significant administrative hurdles that affect both providers and patients.

“AI technology really has taken us to the next level, or at least given us a vision of what that next level is, to get as real-time as possible,” Ingham said.

On the payer side, the system facilitates real-time data exchange between providers and insurers, helping detect and resolve issues at the point of claim submission. This process aims to bring greater clarity to reimbursement workflows for healthcare stakeholders.

Puneet Maheshwari, Senior Vice President and General Manager of Optum Real, said engaging key partners early was crucial for the platform’s success.

“UnitedHealthcare's size and scale, in particular, help generate an upward vortex that can create the momentum that's needed to be created in the ecosystem,” he noted.

He added that collaboration with Allina Health provided “a critical proof point” for the technology’s effectiveness.

Allina Health is now exploring the potential expansion of the pilot to other service lines, including surgical procedures. Maheshwari emphasized that UnitedHealth Group’s commitment to this approach will rely on broader participation across the healthcare ecosystem.

“Those two things combined are what's needed and is the recipe for success,” he said.

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