How to Insource Payment Integrity Audits – Part 1: Maximizing What You Have
Insourcing audits is one of the biggest strategic shifts a PI team can make. Done right, it reduces costs, improves efficiency, and gives health plans greater control. But success doesn’t start with adding new audits — it starts with maximizing what you already have.
Step 1: Optimize Existing Audits
1. Smarter Selection: Use historical data and machine learning to target high-value claims. The result? Higher hit rates, less abrasion.
2. Boost Auditor Efficiency: Replace manual reporting with automated platforms so auditors can focus on high-level analysis.
3. Automated Workflows: Prioritize claims by risk, retrieve documents instantly, and reduce human error.
4. AI-Powered Insights: Predict patterns, flag anomalies, and use GenAI to summarize findings and escalate quickly
Step 2: Embrace Granular Reporting
Detailed reporting is not optional — it’s essential. Insights into conversion rates, bottlenecks, and provider trends enable continuous refinement of audit strategies. Reporting also drives provider collaboration by highlighting recurring issues and education opportunities.
Step 3: Centralize for Scale
Point solutions create silos. A centralized platform consolidates chart repositories, automates workflows, and enables collaboration across PI, utilization management, and risk adjustment. The result: lower costs, fewer errors, and a single source of truth.
The Lyric Difference
Lyric enables PI teams to get the most out of their existing audits with advanced automation, AI insights, and seamless reporting — setting the stage for successful insourcing at scale.
Start maximizing your current audits today. Learn about Replay
About Lyric
Lyric is the payment integrity Al company trusted by the nation's leading health plans at the beginning of the claims payment workflow. The Lyric platform is built on Al from the ground up and trained on 35 years of clinical expertise with real time integrations across 190 million lives. Lyric reduces wasted healthcare spending and ensures fast, accurate payments that drive transparency between payers and providers. Lyric is recognized as the 2025 Best in KLAS for Pre-payment Accuracy and Integrity.
