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, formerly ClaimsXten, is a leading AI healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated, expert teams, and top technologies help deliver up to $14 billion of annual savings to our many loyal and valued customers—including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric is investing in AI driven technology to ease implementation and speed to value for customer savings, while offering enhanced and newly available solutions through internal product development and strategic partnerships, including recently announced partnerships with Concert Genetics, Autonomize AI, and now, Codoxo. Discover more at Lyric.ai.
