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Outpace Policy Change: Keeping Your Edit Strategy up to Speed

Shift Technology

01:02:02

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Healthcare moves fast. Your edits should too.

In 2025, health payers took on 420 CPT code updates, 550 ICD-10 changes and countless new or shifting policies. On top of this, providers are under their own innovations, leading to an increase in claims and billing complexity. Every change that moves faster than your edit updates can drive more costly errors. The downstream cost of falling behind is real. Improper payments pass through, edits misfire, and provider appeals become harder to defend. This panel will discuss how health plans are leveraging AI and agents to keep their edit strategy up with the pace of healthcare change.

The panel will explore:

  • The pace of change in healthcare policy, coding, and care delivery, and why edit programs struggle to keep up
  • The operational and financial impact of edit drift, and how to recognize when your program is falling behind
  • What effective edit governance looks like in practice, from both a health plan and technology perspective
  • How AI and agentic technology are shifting what's possible, from automated policy monitoring to faster edit generation and more defensible resolution

Speakers

Jesse Montgomery

Jesse Montgomery

Head of Value Engineering & Customer Success US Healthcare, Shift Technology

Mark Starinsky

Mark Starinsky

Product Lead US Healthcare, Shift Technology

Priscilla Alfaro

Priscilla Alfaro

Executive Medical Director & Payment Integrity Leader

Ankur Verma

Ankur Verma

Vice President, Everest Group

Outpace Policy Change: Keeping Your Edit Strategy up to Speed

01:02:02

Watch