WOW, shiny new Optum Real is GREAT!
• When it determines payer reimbursement…
o does it harmonize amounts for all Providers in a State/Region/Market?
• When it checks a patient’s plan’s provider network…
o does it eliminate “out of network” ensuring full coverage?
• When it bills the patient and OFS debits their Optum HSA at point of service…
o does the provider get reimbursed in real time, too?
• When it looks up patient coverage…
o does it standardize coverage and simplify all covered lives in a few formats for all plans?
• When it uses AI to scan thousands of provider contracts and patient benefit documents…
o does “Steve’s Catholic school social responsibility” compel it to publish and address disparities of an opaque, for-profit Payer system that puts patients with high-deductible plans and out of pocket costs into medical debt?
• When it confirms employer coverage…
o does it ensure all employers including those self-employed are charged the same premiums for covered lives across ten-year age cohorts?
• When it saves tons of money by boosting efficiency and cutting labor…
o does it pass it back into the system or fund new products to sell at high margin?
15 replies (most recent on top)
Wonder if the UHG CFO firing will get posted on Facebook?
When I heard “I want us to be a social media company” after “AI bro, yo bro… bro… ever heard of AI, bro?” The first part of the meeting I was just stunned.
Everyone on the floor was wondering what the he-l is going on next.
My bet is: “I want us to be a beef je-ky and ice cream company” when neither of these pan out, why not?
@br+1k83tg0jt. EPIC already has AI assisted visit notes. Nothing new. Reading some of the notes many times you wonder was i even in the room I dont remember any of that conversation in the notes
It's only for UHC benefit .
@e8 cute you think anyone left has integrity!
@OP Exodus of departures is already underway including in SD's inner orbit and people he's sparred. Continued aloof, misguided leadership will not bode will for retention of anyone that has an ounce of intelligence or integrity.
@ac UHG is hated by consumers and businesses who want to see our demise. We have clients in the provider space because they don't have a choice or time to source 12 solutions and we have 9 of them.
Epic will reach a "good enough" point perhaps 2026 and allow Providers access to the free version of Optum Real to submit claims as it replaces the old network products (surprise, those products/jobs are going away!). If Optum doesn't play nice with Epic, they will simply plug Providers into their own Payer Gateway and bye bye Optum.
OR may be a nothingburger and Providers will want free access to join and it sits as a Payer product until Epic does it cheaper/better/less evil
@at no one should presume UHG is anything but evil, I don't think that's the OP's point. We're experiencing the Infosys/Wipro conversion of UHG which will more swiftly bring demise.
What makes Info-pro model successful is operating behind the scenes of consumer/public facing brands. When you take a high profile, publicly disliked, consumer facing company like UHG add a "cut cost, move fast, no planning, offshore" culture and then want to tell the world, you will absolutely be put on blast for BS
I don’t like they basically said Ai will go through a provider visit note and “fix” things. Almost like it will just make up what happened during the visit to “fill in the spaces”. Scary thought.
That was embarrassing!
@ac Optum EHR services around 800 employees now, bit integrator for Epic Medical records..watch out
This was until a year ago a Fortune 10 middleman company and not the Boy Scouts. Anyone expecting benevolence here must be very new to the workforce in general.
Just because EPIC reportedly has some so called wonder product does not mean all the Hospital and provider groups will hop on board. Look how long it took to get then on just administrative electronic claims from paper. Yes the current system is broken you are delusional if you think the medical industrial complex is going to move with the speed of light to change anything. This is not some startup it is just a variation of a bank. Smoke and mirrors. A bunch of people will be leaving via offshore and possibly AI for some areas that is about it.
"Claims process is broken" - Well when you sell milk at 127 different prices don't blame the cow.
grab the popcorn!