Smart tech and AI for faster, safer, lower cost pharmacy benefits

[00:00:05] Speaker: Healthcare is complex and it doesn't need to be. With ai, we can simplify the [00:00:15] journey.  

[00:00:16] Speaker 2: Pharmacy benefit navigation is just too hard, and so the first thing with members is really how do we solve those real problems? In a simple way, [00:00:25] we're excited about the capabilities we're bringing forward with Optum assistant to do exactly that, helping the member navigate in a way that is seamless, conversational, and easy. 

[00:00:34] Optum [00:00:35] assistant is a key enabler of how we're gonna bring AI to all of our stakeholders. Whether that be a member on their mobile app or a client [00:00:45] that may be on Benefit Central, our client portal. 

[00:00:50] Speaker: If we can give our members and patients access to the answers they need when they [00:00:55] need it, they're gonna get the healthcare they need. We have AI powered conversational voice and chat bots in our call centers. These voice bots and chat bots allow our members to get the answers they [00:01:05] need using conversational ai. 

[00:01:06] We have AI models that can predict member and patient abrasion. We have AI models that look at all the consumer data and predict if a member [00:01:15] is gonna run into an issue. When that happens, we can reach in and proactively remove that barrier to avoid escalations.[00:01:25]  

[00:01:25] Prior authorization is a source of frustration for providers, but we also know that prior authorizations are important for patient safety and affordability. So our challenge was to find a solution [00:01:35] that removed the administrative burden from providers. But allowed us to turn around the decision time for prior authorizations in a more timely manner to get patients onto therapy faster. 

[00:01:43] Together with a large [00:01:45] industry partner, we co-created a solution that automates the creation submission and approvals of prior authorizations. In less than 29 seconds, [00:01:55] we're seeing a 68% reduction in denials, and we're seeing an 88% reduction in appeals, which means we're getting it right the first time. 

[00:02:03] And the best part is we're [00:02:05] getting patients onto therapy up to four days faster. 

[00:02:11] Plan sponsors will feel the difference of our AI solutions in [00:02:15] Twofolds. One as a benefit plan manager, they'll be able to get the information they need when they need it, whether they're using the Optum assistant or they're in Benefits Central, [00:02:25] and they're able to look up. Prior authorization statuses, why claims rejected yet trend analytics, but they'll also feel it because their members will have fewer [00:02:35] abrasion points and fewer escalations. 

[00:02:37] And a happy member is a happy benefit plant manager.[00:02:45]  

[00:02:45] Speaker 2: I'm most excited about our thousands of use cases we have in motion to really support providers, members, and clients. In a significant way, really [00:02:55] transformed by the power of [00:03:05] ai.