Outpace Policy Change: Keeping Your Edit Strategy up to Speed
Shift Technology
01:02:02
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
Head of Value Engineering & Customer Success US Healthcare, Shift Technology
Mark Starinsky
Product Lead US Healthcare, Shift Technology
Priscilla Alfaro
Executive Medical Director & Payment Integrity Leader
Ankur Verma
Vice President, Everest Group
Outpace Policy Change: Keeping Your Edit Strategy up to Speed
01:02:02