As artificial intelligence takes a front seat in revenue cycle operations, providers are confronting a fast-changing landscape shaped by payor-driven automation. Denials are being issued in seconds. Post-payment reviews are ramping up. And compliance, once a back-office function, is now a strategic necessity.
In this special Office Hours session, Stuart Newsome distills the most important insights from his AAPC HEALTHCON presentation and a prior HFMA segment—delivering a clear-eyed look at the AI arms race between payors and providers. The session will examine how payors are deploying AI to control costs, how providers can avoid costly compliance missteps, and what governance structures are needed to keep automation accountable.
Attendees will leave with a practical understanding of the risks and remedies surrounding AI in healthcare RCM, plus actionable steps to build resilient compliance programs that evolve with the technology.
Learning Objectives
- Recognize How Payors Use AI to Deny and RecoupGain visibility into real-world insurer tactics and understand how AI accelerates utilization review and claim rejection.
- Spot Compliance Vulnerabilities in AI ToolsLearn how flawed datasets, lack of transparency, and PHI mishandling create compliance risks—often without warning.
- Apply Practical Oversight and Governance TacticsExplore best practices for establishing internal audit trails, explainable AI standards, and human-led governance to mitigate risk.
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