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Deploying AI effectively and responsibly in payment integrity

Watch our Payment Integrity Pulse webinar on demand

Watch the on-demand webinar

More than 85% of surveyed payers say they’ve either implemented or are exploring proofs of concept for generative artificial intelligence (AI), according to McKinsey, which estimates that payers could save up to 25% in administrative costs and 11% in medical costs with currently available AI technology. But health plans and their external partners must have responsible controls in place when deploying AI within payment integrity programs to avoid harm to data security, accuracy, transparency, privacy, and other areas of risk.

The third webinar in Cotiviti’s Payment Integrity Pulse series features industry AI experts discussing the latest trends for payers and the responsible payment integrity use cases driving direct payer value with minimal risk.

Watch our latest on-demand webinar in the series as we examine:

  • The current state of payment integrity AI for payers
  • A framework for responsible AI use
  • Successful and upcoming use cases for payment integrity

Presenters:

Brett Arnold

Brett Arnold
Senior Vice President, Product Development
Cotiviti

Brett’s role is to understand client needs and lead the process of enhancing Cotiviti’s product portfolio to meet them. This involves engaging with clients, understanding market needs, leading product discovery, developing market strategies, building business cases, managing a product roadmap, defining solutions, and leading market launches.

Demi Plessas, Ph.D.

Demi Plessas, Ph.D.
Principal Data Scientist
Edifecs, a Cotiviti Business

Dr. Plessas architects AI solutions that have transformed payment integrity and value-based care analytics across the healthcare industry. Their innovative bundle-specific risk adjustment models currently process over 1.8 billion claims annually, delivering 20% greater accuracy than industry alternatives while helping ensure fair outcomes for vulnerable populations including dual-eligible and LTSS members. Recognized for excellence in mathematical communication through the prestigious Carl B. Allendoerfer Award, Dr. Plessas brings unique expertise in explainable AI and bias detection to responsible AI deployment in healthcare. They have advised CMS, the VA, and Department of Energy on implementing transparent and validated AI systems and have academic publications proposing the use of social determinants in the execution and payment of value-based care contracts.

Daria Finney

Daria Finney
Manager of Data Science
Cotiviti

Daria specializes in applying advanced analytics and machine learning to solve complex business problems, with a focus on driving actionable insights and value for Cotiviti’s clients. With a deep background in mathematics and statistics, she has developed machine learning solutions that support a variety of use cases for Cotiviti’s Clinical Chart Validation solution suite.

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