One-to-One Meetings
The Highlights
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Advanced AI in Healthcare Payment Integrity: A Provider Centric Approach
How can advanced AI help improve claims accuracy - even more so than traditional claims editing technologies?
In a recent report in collaboration with 4L Data Intelligence, we delved into how a provider-centric approach to claims editing, when combined with cutting-edge, patented AI technology, is transforming Fraud, Waste, and Abuse (FWA) detection throughout the claims workflow.
This comprehensive analysis offers valuable insights for payers seeking to elevate results from the traditional, claims data-centric approach to claims management. By adopting these innovative strategies, payers can significantly enhance their ability to maximize cost savings.
Optimizing AI in Healthcare Payment Integrity
Advancements in artificial intelligence (AI) technology can improve claims accuracy, fraud detection, and operational efficiency for healthcare payment integrity – ultimately decreasing costs and enhancing the provider and patient experience. The rapid evolution of AI in the last year has exceeded technological advancements in payment integrity in the last decade, with GenAI and NLP enabling automated interpretation of clinical documentation that could never be achieved before.
We have interviewed payers, vendors, and other key stakeholders on their insights, with the goal of providing actionable best practices for payers to augment their AI implementation efforts.
State of Union Industry Report
Pressures across the healthcare sector are growing and payment integrity is set to become even more entrenched in driving savings as well as fostering trust and transparency.
In collaboration with payers from the HPRI Network and AMS, we have developed a State of Union Industry Report that evaluates the current trends in the payment integrity market from a payers perspective. It will also look at disruptive technologies that are enabling greater analytics for unstructured data, as well as opportunities for future savings in the coming year.
