- In May 2025, Optum introduced Optum Integrity One, an AI-driven integrated revenue cycle platform designed to enhance clinical documentation and coding accuracy. The platform automates tasks from point of care through final coding, streamlining the billing process and reducing administrative burdens for healthcare providers
- In April 2025, Oracle introduced advanced AI-driven tools to bolster fraud detection in medical claims. These tools leverage machine learning and natural language processing to analyze vast amounts of healthcare data, identifying patterns indicative of fraudulent activities such as upcoding and phantom billing. By automating the detection process, Oracle aims to reduce false claims and enhance the accuracy of reimbursements
- In April 2025, MedAI Solution highlighted the use of AI in real-time medical billing fraud detection. By employing natural language processing, machine learning, and automation within healthcare revenue cycle management systems, AI can proactively identify and prevent fraudulent billing activities before claims are processed, thereby safeguarding healthcare finances
- In April 2025, Deloitte published insights into the application of AI-powered multimodal technologies in detecting fraudulent behaviors across the insurance claim lifecycle. These technologies analyze various data sources to identify anomalies and potential fraud, helping insurers mitigate financial losses and improve operational efficiency
- In April 2024, Cognizant partnered with FICO to launch a cloud-based real-time payment fraud prevention solution. This AI-powered system aims to help banks and payment providers detect and prevent fraudulent transactions in real-time, enhancing security in the digital payment landscape
