From Pay-and-Chase to Proactive: How AI Is Transforming Payment Integrity
Annual U.S. healthcare spending has surpassed $4.9 trillion, with nearly 15% lost to fraud, waste, and abuse. For payers operating on razor-thin margins, this is a critical challenge. But there’s a solution: AI-powered payment integrity programs.
In this exclusive report, From Pay-and-Chase to Proactive: How AI Is Transforming Payment Integrity, we explore how AI is reshaping the payment integrity landscape, enabling payers to move from reactive “pay-and-chase” models to proactive prevention of improper payments. Learn how leading health plans are leveraging AI to reduce costs, improve efficiency, and strengthen provider relationships.
What you’ll discover:
Actionable insights from industry leaders and real-world implementations
- The current state of AI adoption: How did we get here, where are we now, and where are we headed? While adoption levels vary widely, AI implementation is steadily growing, with rising investments, especially among industry leaders."
- AI technologies transforming the payment life cycle: Learn which types of AI, automation and analytics are being implemented by industry leaders and how these technologies are reshaping PI workflows.
- Real results from early adopters: See how AI is driving the shift from reactive to proactive prevention and the impact of embedded intelligence and automation across payment life cycle
- What’s needed for success: How to scale AI at a pace your organization can handle, including actionable advice on building AI-powered payment integrity programs, from data preparation to modular adoption strategies.
Why this matters now
The healthcare industry is at a tipping point. With AI adoption accelerating, payers that fail to modernize risk falling behind. This report provides the insights you need to stay ahead of the curve, reduce costs, and improve operational efficiency.
"Our industry is on the verge of a seismic shift. In pharmacies, benefits are determined instantly at the point of service– there’s no six-month wait to understand coverage or costs. In most other areas of healthcare, however, there is still a significant delay between care delivery and claims processing that can lead to waste, errors, and payment leakage. As data becomes more seamlessly integrated and accessible across systems, AI can enable the same kind of real-time decisioning across the broader healthcare ecosystem—allowing payers to receive claims the moment they are submitted and process them immediately."
Arun Rangamani
Senior Vice President,
Payment Services, EXL
Download the report
Ready to transform your payment integrity program? Download From Pay-and-Chase to Proactive: How AI Is Transforming Payment Integrity today and discover how AI can help you achieve immediate savings, streamline operations, and build stronger provider relationships.