Jul 24, 2025 | AI for PI Community, Payment Integrity
At the AI for PI Summit 2025, Lynn Garbee, Partner at HealthScape Advisors, delivered a strikingly candid and strategic session that struck a chord with payment integrity (PI) professionals and healthcare industry leaders. Drawing from decades of experience, she made...
Jul 24, 2025 | Payment Integrity
Rethinking Payment Integrity at the Concept Level In the face of rising healthcare claims complexity, mounting healthcare payer administrative costs, challenges around payment accuracy, and strained provider relationships, payment integrity professionals are...
Jul 10, 2025 | AI for PI Community, Payment Integrity
Navigating a Pivotal Inflection Point The U.S. healthcare system stands at a critical juncture. With the cost of care continuing to rise (up to $400B due to administrative waste) and provider burnout reaching unsustainable levels (43% as of 2024), stakeholders...
Jun 26, 2025 | Payment Integrity
The healthcare payment system is hemorrhaging money, and the traditional “detect and recover” approach in payment integrity is not just failing—it’s actively making the crisis worse. While payers and providers continue to operate under outdated...
May 28, 2025 | Payment Integrity
The U.S. healthcare system is at a breaking point. Healthcare payers are managing overwhelming claims volumes, with fraud schemes and improper payments costing the industry billions in wasted dollars each year. According to industry data, the administrative burden...
Feb 20, 2025 | AI in Healthcare, Payment Integrity
Navigating MLR Compliance with AI-Powered Healthcare Cost Containment Newsflash: Pressures are escalating for healthcare payers again. Faced with intense expectations to manage rising administrative costs while complying with strict medical loss ratio (MLR)...
