From Detection to Prevention: AI’s Role in Payment Integrity
In this episode, Steve Sutherland, Senior Vice President of Information Systems at CERIS, shares how AI and machine learning are reshaping payment integrity across the full claims lifecycle. He discusses the shift toward prepayment solutions, the importance of governance and data quality, and how leaders can balance automation with accuracy, fairness, and trust.
“It’s truly an exciting time to be working in this industry and at the intersection of payment integrity and technology. We’re watching AI reshape not just healthcare, but nearly every industry. And the pace of innovation is just accelerating daily. So the work we’re doing now will define the next generation of accuracy, fairness, efficiency in the healthcare space. The future of AI-driven payment integrity isn’t really just about more automation. It’s about trusted, transparent, human-aligned intelligence that’s embedded across the entire claim lifecycle.”