Payment integrity is evolving from a downstream claims audit function to a proactive, critical lever for upstream cost avoidance. Payment integrity leaders note that ‘shifting left’ can cut administrative duties by at least 10-15%, in addition to improving provider abrasion. But evolving to cost avoidance not only requires a shift in mindset, but an evolution in how data, AI tools, and cross-functional collaboration are used to enable proactive decision making.
- Case studies: Critical strategies for launching pre-pay programs and measuring ROI
- How AI is expanding pre-pay capabilities and required governance
- Rethinking the impact and attribution of provider education initiatives
Speaker(s):
David Kagan
Chief of Healthcare Delivery
LA Care
Linde Wilton
Senior Director of Operations
Provider Partners Health Plan
Philip David
Manager, Program Integrity Unit
Sentara
Time:
12:15pm
Agenda Track No.:
Track 2
Session Type:
Panel
Force Inline Description:
0