AI can help align payers and providers to overcome inefficiencies

In a recent interview with Susan Morse, executive editor of Healthcare Finance News, Lalithya Yeramilli, head of payment solutions at Cohere Health, discusses how artificial intelligence (AI) is reshaping payer-provider collaboration by addressing long-standing inefficiencies and misaligned incentives across the care continuum.

Both health plans and providers are now turning to AI to modernize burdensome legacy workflows and address those inefficiencies. Providers are using the technology to drive more timely, accurate payments, while health plans work to streamline the prior authorization process and support human reviewers with real-time clinical and payment insights.

Lalithya explains that this "AI ping pong" is often a result of misaligned incentives. "We see a way forward. It starts from thinking of this not as a battle, but as a collaborative effort that benefits both parties." Cohere Health's approach is grounded in trust, transparency, and continuous human oversight; AI augments human decision-making-never denying care or payments-helping advance a more connected, collaborative healthcare ecosystem.

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