PHILADELPHIA, PA — Healthcare technology company Lyric reports that major health insurers are using new artificial intelligence-driven orchestration capabilities in its Lyric42 platform to coordinate payment decisions and reduce administrative costs tied to claims processing and payment disputes.
The platform’s new capabilities are designed to help health plans make more consistent payment decisions by coordinating rules, workflows and payment integrity products before claims move through the system, the company said.
The move comes as insurers face mounting pressure to reduce administrative waste and improve payment accuracy while limiting disputes with healthcare providers.
Traditional payment integrity systems often rely on isolated edits and sequential workflows that can generate inconsistent decisions and unnecessary audits, according to Lyric. The company said its orchestration technology dynamically prioritizes and reconciles payment decisions by incorporating policy context, historical outcomes, provider impacts and reimbursement risks.
“Healthcare payment accuracy requires more than automation alone,” Chief Executive Halsey Wise said in a statement. “It requires intelligence that is explainable, governed, and aligned to real operational objectives.”
Lyric said the technology is intended to reduce unnecessary claim denials and audits, improve payment consistency and lower administrative costs for both insurers and providers.
“The healthcare system can be chaotic and inefficient,” President and Chief Financial Officer Ravi Umarji said in a statement. He added that the platform’s orchestration capabilities provide health plans with greater visibility and control over technology and workflow decisions.
The company positions the new capabilities as part of a broader push into what it calls healthcare decision intelligence, combining artificial intelligence, data, policy frameworks and deterministic rules to support claims processing.
“Every recommendation can be traced to the policy, data, and logic behind it,” Chief Technology Officer Yevgeny German said in a statement. “That transparency is what makes the technology trusted in a healthcare environment.”
Lyric said health plans retain control over business rules and review thresholds, with the platform designed to augment, rather than replace, human decision-making in claims administration.
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