Small Group Discussions of Real-Life AI Use cases
Mr. Joji Takamoto
VP, Health, Head of Koyoto
Plug & Play Japan
Mr. Rifan Kurnia
VP of Technology & Data
eFishery
Erik Chase
Sr. Director of Claims Integrity
L.A. Care
AI for PI (Christopher Draven, Crystal Son)
AI for Governance (Crystal Son, Simi Binning)
Revolutionizing Claims Processing: Responsible AI Strategies for Efficiency and Compliance (Fireside chat moderate by Dutch Noss)
Explore how responsible AI can revolutionize healthcare claims processing, payment integrity, and coordination of benefits. Learn actionable strategies for automating data workflows, improving claims adjudication, detecting fraud, enhancing compliance, and reducing member abrasion. This Fireside Chat will demonstrate how AI-driven insights streamline operations, reduce errors, and ensure financial and regulatory excellence.
Learning Objectives:
- Streamline Claims Processing: Leverage AI to automate workflows, improve accuracy, and reduce errors.
- Enhance Payment Integrity: Detect fraud, manage denials, and resolve overpayments efficiently.
- Optimize COB Management: Utilize AI for real-time eligibility checks, dynamic rule updates, and accurate payer sequencing.”
Payment Integrity
Moderator
Dutch Noss
Product & Strategy Officer
Alivia Analytics
Dutch Noss is a seasoned leader with over 25 years of expertise in Payment Integrity and Claims Processing, renowned for his pioneering approach to integrating responsible AI and machine learning into operational strategies. As Chief Product & Strategy Officer at Alivia Analytics, he drives innovations that improve accuracy within claims platforms. Dutch has held key leadership roles at various vendors and healthcare plans. A respected speaker at major healthcare conferences, he is recognized for blending deep industry knowledge with cutting-edge technology to shape the future of payment integrity.
Christopher Draven
Senior Director of Payment Integrity Analytics & AI
HCSC
Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.
Crystal Son
Executive Director of Enterprise Data Analytics Solutions
HCSC
Crystal Son is an Executive Director of Enterprise Data Analytics Solutions at Healthcare Service Corporation (HCSC). She has 19 years of experience in deriving intelligence from data.
At HCSC, she leads the Strategic Initiatives & Partnerships team, a department that focuses on cross-functional, collaborative analytics delivery on key programs such as Payment Integrity and Stakeholder Engagement, enterprise data and analytics strategy and planning, as well as design and execution of HCSC’s Responsible AI program. She is passionate about real-world applications of data-driven insights, storytelling through data, and building high-performance teams.
Simi Binning
Responsible AI Lead
HCSC
Simi Binning is an accomplished healthcare professional with over a decade of experience in developing and executing successful strategies that drive business growth. Currently serving as a Responsible AI lead at HCSC, her focus is on AI governance and innovative problem solving.
Alivia Analytics
Website: https://www.aliviaanalytics.com/
Your most expansive Payment Integrity and FWA partner for medical, pharmacy, vision, and dental claims. This features our powerful, configurable Alivia 360™ Platform that provides pre- and post-payment flexibility and considerable cost savings across the healthcare claims management process. It seamlessly transitions between FWA detection and Payment Integrity solutions including clinical and non-clinical audit scenarios, first- and second-pass claims editing, and COB/TPL. Alivia 360™ not only ensures comprehensive financial oversight but full adaptability to operational needs. Alivia integrates AI as an assistant, not a replacement, prioritizing ethical use, human oversight, and compliance with industry standards. Our solutions are offered as SaaS or tech-enabled services that build strong cases against inappropriate billing practices, identify new recoveries missed by legacy vendors, deliver actionable analytics, and offer automated corrections. Alivia enables healthcare payers to streamline vendor management, improving control and strategic decision-making. Schedule a discovery meeting and demo.