ENHANCE
Run payment integrity on your own terms
Operate your own program on one data set, in one view. Author your own content, run your own audits, and show providers the policy behind every finding. Lyric supplies the tools. You keep control.
Proof your team can do more
+50K
Health Plan
Self-Authored policies4-5x
Increase In Auditor Productivity
75%
Reduction In Claim Write Offs
The Payment Integrity Shift
From vendor-led to plan-run
Legacypayment integrity scales by adding vendors. Performance plateaus, another vendor comes in, and the program grows harder to govern and moreexpensive to manage. Payment integrity leaders lack the full view ofperformance and the tools to hold partners accountable. Program controlrequires your own content, your own audits, and one view of everything.
what lyric delivers
Lyric brings content development, audit enablement, operational intelligence, provider transparency, and program management into one environment. Author your own content, run your own audits, and see performance across every vendor. Your teams work on decisions instead of coordination.
Expand what your team can do.
Enhance Solutions
One platform. Your content, your audits, your call
Your Knowledge
Deployable Content Measured Impact
Put Enterprise Knowledge to Work
Transform your health plan policies and documents into actionable payment integrity content that can be authored, deployed, and enforced at scale with Policy Studio.
Move From Idea to Impact
Design, model, test, approve, and deploy new payment integrity content in one environment. Proven frameworks, intelligent assistance, and embedded governance shorten the path from opportunity to production.
Connect Policy to Performance
Policy Studio links content development to program objectives, so you can evaluate performance, validate impact, and refine content against real-world results before deployment.
Build a Repeatable Capability
Content authoring, lifecycle management, analytics, and governance run in one operating model, turning individual ideas into scalable capabilities that improve over time.
Targeted Audits
Standardized Execution
Higher Throughput
Focus Audits Where They Pay
Replay combines analytics, prioritization, and configurable workflows to identify what matches your audit criteria, automates manual workflows, and standardizes execution so audits are handled consistently. Audit yield and productivity rise without adding headcount.
Standardize Execution Across Every Program
Coordination of Benefits, DRG Validation, Itemized Bill Review, high-dollar claims, and quality reviews run on one operating framework for identifying, performing, and managing audits.
Accelerate Throughput
Workload management, automation, integrated QA, document management, and reviewer tools let teams complete more reviews at the same quality. Transform audits from labor-intensive processes into technology-enabled workflows.
Turn Audit Data Into Improvement
Replay shows productivity, savings, audit quality, reviewer performance, and operational trends, so you can identify improvement opportunities and continuously optimize how payment integrity work is performed.
One Command Center Coordinated Work
Full Visibility
One Operational Environment
Claims, audits, recoveries, appeals, documents, financial outcomes, and vendor activity in a single system. By bringing disconnected data, processes, and stakeholders together, health plans gain visibility into performance across the payment integrity lifecycle.
Coordinate and Govern Complexity
Standardized intake, prioritization, routing, execution, and resolution across teams and vendors ensures nothing falls through the cracks and no work is duplicated, while a single set of business rules and exclusions governs all programs, vendors, and audit types.
Hold Every Vendor to the Same Measure
Evaluate vendor performance, compare outcomes, identify bottlenecks, and understand what is driving results across the program. Actionable insights allow you make more informed decisions about where to invest time, resources, and effort to increase program effectiveness.
Scale Value Creation, not Headcount
Intelligent selection, workflow automation, and dynamic reporting provide the operational foundation needed to coordinate a growing ecosystem, increase agility, and improve performance without adding administrative burden.
Explain Every Outcome Trace All Decision Rationale Build Provider Trust
Clear Visibility Into Payment Decisions
Direct provider access to the policies, clinical rationale, and reimbursement guidance that drive payment decisions make determinations easier to understand. Improve transparency while creating greater confidence in outcomes.
Accuracy Before Claims Are Submitted
Test claims against payment policies and editing logic before submission, identifying potential issues before they become denials, adjustments, or rework. By validating claim quality upfront, providers can improve first-pass accuracy and reduce resubmissions.
Lower Appeals, Disputes, and Abrasion
Provide structured explanations, supporting rationale, policy context, and what-if tools to reduce unnecessary provider disputes, streamline communication, and improve operational efficiency for both health plans and providers.
Promote Compliance Through Clarity
Payment decisions become actionable learning opportunities by giving providers visibility into the policies, rationale, and reimbursement requirements. Greater understanding improves compliance and submission accuracy.
The Lyric Difference
Internal Capability
Coordinated Execution
Full Visibility
- Connected Applications: Policy Studio, Replay, Virtuoso, and C3 work together as one coordinated suite.
- Operational Intelligence: See performance, productivity, opportunities, and outcomes across the payment integrity lifecycle.
- Coordinate the Full Program: Manage teams, vendors, audits, content, and workflows from one operational environment.
- Transparency and Alignment: Shared visibility, rationale, and performance insights improve collaboration across stakeholders and providers.
- Shift In: Equip internal teams with the tools, intelligence, and workflows to create more value before directing work outward.
- Technology That Scales Expertise: Extend clinical, coding, policy, and payment integrity expertise through purpose-built applications.
HEALTHCARE DECISION INTELLIGENCE FOR YOUr CONTENT
Multiple signals on every claim
One reconciled recommendation
Content you author and audits you execute run on Lyric42 alongside other signals, reconciled against your configuration.
Frequently Asked Questions
Enhance is a suite of applications that lets a health plan run its own payment integrity program. Policy Studio authors deployable edits, Replay automates and standardizes audits, Virtuoso coordinates the full program including vendor activity, and C3 gives providers access to the policy behind a finding. Lyric supplies the tools. You keep control.
Policy Studio turns your medical policies, reimbursement policies, provider contracts, and plan documents into pre-pay edits you can deploy. Replay identifies and executes audits on one automated operating framework. Virtuoso centralizes claims, audits, recoveries, appeals, and vendor activity. C3 shows providers the policy to help prevent errors before claim submission.
Maximizing the value created in-house optimizes overall program ROI. The legacy model adds a vendor whenever performance plateau. That makes programs harder to govern and more expensive to manage, and it leaves payment integrity leaders without a full view of performance.
Yes. Design, model, test, approve, and deploy new content in Policy Studio.
No. Enhance expands what internal teams can handle and gives you the visibility to measure every vendor. You decide what work stays outside.
