AI agents are already processing prior authorizations, adjudicating claims and driving member outreach at scale. But an agent is only as trustworthy as the data grounding it. When member identities, benefits and authorizations are fragmented, agents make confident but wrong decisions; and the cost lands on margins, compliance and member trust.
This session breaks down the reimbursement integrity gap threatening payer operations and how a trusted context architecture closes it. By unifying fragmented data into a governed golden member record, payers give AI agents the accuracy and oversight to operate safely and compliantly.
Learnings include:
- How to eliminate identity fragmentation that drives costly benefit hallucinations
- How to enforce real-time HIPAA and CMS compliance guardrails across agentic workflows
- How payers cut prior authorization approvals from days to hours
- Where payers are finding 15 to 20% administrative cost reductions through MLR optimization
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