A provider receives a denial on a high-cost claim they believed was clean and compliant. No explanation, no context — just a rejection. What follows is predictable: Overloaded call centers, delayed resolutions and a costly back-and-forth that strains relationships.

For many health plans, this kind of friction isn’t the exception — it’s the norm. And it’s not just frustrating. It’s expensive, inefficient and damaging to provider relationships.

But here’s the good news: payment integrity doesn’t have to be a source of abrasion.

In fact, when done right, it can be a powerful driver of operational efficiency and trust.

Take a look at four strategies that can help you modernize your approach and make payment integrity work better for everyone involved.

1. Pair AI with Human Expertise for S

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