Reframing the AI ‘Arms Race’ - Aligning Payers & Providers on Shared Outcomes for AI | Kisaco Research

Providers are quickly integrating AI into their documentation, coding, and appeals workflows. Plans are using AI to flag anomalies, automate review, and catch coding errors at scale. Many plans perceive provider AI use as a negative force driving more coding intensity and upcoding. But how can AI use by payers and providers be reframed to drive real-time, accurate claims adjudication that saves costs on both sides? This panel discussion brings together leaders from both perspectives to brainstorm collaboration strategies.

- Provider perspective: The impact of AI tools on claims accuracy and ‘coding intensity’
- Payer perspective: The impact of AI tools on provider relationships, communications, and perspectives on ‘coding intensity’
- How AI can be leveraged to enable collaboration and real-time claims adjudication

Speaker(s): 

Author:

Linde Wilton

Senior Director of Operations
Provider Partners Health Plan

Linde Wilton

Senior Director of Operations
Provider Partners Health Plan

Author:

Diane Nguyen

Senior Project Specialist, Payment Integrity Planning and Implementation
Priority Health

Diane Nguyen

Senior Project Specialist, Payment Integrity Planning and Implementation
Priority Health

Author:

Neeraj Jaiman

Director of Medical Economics
BCBS NC

Neeraj Jaiman

Director of Medical Economics
BCBS NC

Author:

Corella Lumpkins

Manager of Coding, Compliance and Provider Education
Loudoun Medical Group P.C.

Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.

Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care. 

Corella Lumpkins

Manager of Coding, Compliance and Provider Education
Loudoun Medical Group P.C.

Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.

Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care. 

Time: 
3:00pm
Session Type: 
General Session (Presentation)
Force Inline Description: 
0