UnitedHealth Group Expands AI Use Across Insurance, Pharmacy, & Care Divisions

Story BySaloni Tyagi

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UnitedHealth Group Expands AI Use Across Insurance, Pharmacy, & Care Divisions

All AI use cases are vetted for fairness, performance, and bias before deployment.

UnitedHealth Group has significantly expanded its use of artificial intelligence (AI), with 1,000 AI applications now in production across its insurance, health delivery, and pharmacy segments.

These tools help transcribe conversations from clinical visits, summarize medical data, automate parts of the claims process, and power chatbots that assist customers.

The company also reports that approximately 20,000 of its engineers use AI to assist in software development.

Sandeep Dadlani, Chief Digital and Technology Officer, UnitedHealth Group, said that half of these AI tools leverage generative AI, while the other half use more traditional forms of the technology.

Further, UnitedHealth has maintained that the tool in question does not make coverage decisions.

“AI has a role to play in the claims evaluation process, but it will never be allowed to deny a claim,” said Dadlani.

He explained that the algorithm is used to support, not replace, human judgment.

Industry-wide, over five billion claims are processed annually, and UnitedHealth auto-adjudicates more than 90% of its claims, mostly using rules-based automation rather than AI. The company clarified that AI is involved in only a small subset of these cases and does not independently deny or alter claim payments.

For the 10% of claims that cannot be auto-adjudicated, often due to missing information, generative AI is increasingly being used to gather supplemental data, such as benefits policies from employers. In these cases, AI may either approve the claim or escalate it to a human for further review.

To manage risk, UnitedHealth has established a Responsible AI board composed of 20 to 25 members, including clinicians, legal experts, ethicists, and technologists from inside and outside the company. All AI use cases are vetted for fairness, performance, and bias before deployment.

Many of UnitedHealth’s AI applications are focused on administrative efficiency or enhancing customer interactions.

One AI chatbot, for instance, helped users search for doctors by interpreting symptoms like “stomach pain” and directing them to appropriate specialists. This tool handled 18 million queries in the first quarter of 2025.

In clinical settings, doctors in UnitedHealth’s Optum health delivery unit are using AI tools, with patient consent, to record and transcribe medical visits. Another application analyzes patient records to identify potentially undiagnosed conditions, with early results showing that clinicians were twice as effective at spotting medical issues when aided by AI.

Still, public trust in medical chatbots and AI-powered assistants remains mixed. While the World Health Organization introduced an AI health assistant in 2024, experts warned about potential inaccuracies.

Despite these concerns, UnitedHealth is eyeing broader commercial opportunities for its AI tools in the future, with plans to offer some solutions to other healthcare organizations.