As health tech companies build artificial intelligence to automate administrative tasks such as clinical documentation, they also see a huge opportunity to bridge the gap between medical records and payments.
Suki, an AI scribe, works with Optum Real, a real-time claims management system, to orchestrate clinical documentation and revenue cycle workflows in real time, executives from both companies announced last week at the Healthcare Information Management Systems Society (HIMSS) 2026 Global Conference and Exhibition in Las Vegas*.
Optum, a member of UnitedHealth Group, unveiled its artificial intelligence-powered system five months ago at the 2025 HLTH conference, highlighting the company’s goal to remove friction between providers and payers in claims processing and payment workflows.
The Optum Real platform relies on Al for both clinical and financial support at each stage of the claims and reimbursement process, informing providers of coverage in real time and ensuring payers receive more complete claims data that takes into account individual-specific benefits, Fierce Healthcare reported in October.
Optum is piloting Real in partnership with sister health insurer UnitedHealthcare as a payer, as well as Allina Health, a health system that operates 12 hospitals across Minnesota and Wisconsin, and provides outpatient radiology and cardiology services. Optum executives told HLTH that the pilot has reduced administrative errors at Allina and improved the patient experience for the more than 5,000 visits processed to date.
Optum Real will partner with Suki to integrate its AI-enabled infrastructure with Suki’s ambient clinical intelligence platform to support a cleaner downstream claims process, executives said. Suki’s AI solutions include AI ambient scribe, as well as revenue cycle assistance and clinical reasoning capabilities. The company’s technology is available in 100 medical specialties and 81 different languages and works with more than 400 health systems and other partners.
Nearly 15% of reimbursement claims submitted to private payers are initially denied, according to Premier data. Punit Soni, CEO of Suki, noted that health systems are plagued by inefficient and disconnected systems for tasks such as documentation, coding, and billing, leading to delays and rework. These inefficient revenue cycle management workflows add tremendous costs to the healthcare industry.
The end-to-end reimbursement flow in U.S. healthcare is broken, Puneet Maheshwari, senior vice president of Optum and general manager of Optum Real, said during a panel discussion at HIMSS 2026. “The reason it’s breaking down is because there’s a level of opacity between payers and providers, where the nuances of decision-making are hidden behind mountains of paperwork to manage the complexity of provider submissions. Payers have made significant investments in their processes around integrity, which together represent roughly $300 billion to $350 billion worth of administrative costs,” he said.
Maheshwari and Soni said during the panel discussion that removing manual bottlenecks will improve the accuracy of initial submissions and reduce the risk of rejections associated with late submissions.
Soni said clinical documentation is one way to record what is happening at the point of care. “The logical next step has to be to extract all the financial information from it and remove this friction,” he said.
The goal of the partnership is to provide faster and more accurate billing to reduce administrative waste, executives said. AI could help rethink processes and workflows, “lowering the cost of decision-making,” Soni said.
Soni and Maheshwari are demonstrating early results showing faster documentation-to-claim cycles and fewer avoidable issues.
Heidi Ink RCM Partnership
Optum’s competitor in the revenue cycle management space, R1 RCM, is also increasing its partnership to integrate into clinical workflows. Through the partnership with AI Secretary Heidi announced at HIMSS, the companies will integrate Heidi’s clinical documentation technology directly into R1’s revenue operating system, the companies said in a press release.
Heidi, which first launched in Australia, says it supports more than 2.7 million consultations each week across 190 countries and 110 languages. Through its revenue operating system, R1 translates this clinical intelligence into accurate and compliant billing, avoiding repudiations, preventing defects and improving revenue recovery, the companies said.
Heidi said users will have greater visibility into payer policy information, pre-authorization rules and insurance eligibility information at the point of care. Revenue cycle experts say faster claims processing and greater predictability of reimbursement will result in higher quality documentation being incorporated into claims workflows, executives said.
“Revenue management companies have historically had limited integration with clinicians, while writing companies have lacked system-level payer data. This important partnership changes that. Connect R1’s payer intelligence directly to the Heidi platform at the point of care. Together, we can close gaps that cost billions of dollars across the system,” said Thomas Kelly, M.D., co-founder and CEO of Heidi, in a statement.
Heidi is also expanding its capabilities with the launch of Evidence, a clinical decision support tool that uncovers relevant research during encounters. Although the company is moving into the same space as OpenEvidence, Kelly said Heidi’s business model is distinctly different in that it has no advertising.
Heidi Evidence is built in partnership with HealthPathways, EM guidance, MIMS, Vidal, nice, BMJ Group is particularly committed to ensuring that guidance reflects local standards and formulas. The company says it is committed to non-commercial auditable data.
Heidi Evidence is free to individual clinicians. The company says it uses its corporate profits to subsidize access to practitioners in resource-limited or fragmented markets.
We also developed Heidi Comms as a patient communication and scheduling tool. Kelly says Heidi is evolving from an AI scribe to an AI care partner that connects clinical documentation with real-time clinical reasoning. The aim is to expand clinical capabilities by automating administrative tasks.
*The author moderated the Optum Real-Suki panel at HIMSS 2026
