Algorithm Versus Algorithm: When Provider AI Meets Payer AI

Session Description: Providers are beginning to use AI to support documentation, coding, prior authorization, claims, and appeals, while payers are also expanding their use of algorithms to evaluate medical necessity, utilization, and reimbursement. This session will examine how these evolving technologies may influence denials, audit exposure, documentation expectations, and the balance of power between providers and payers. Panelists will discuss what behavioral health organizations should be watching as both provider- and payer-side AI becomes more sophisticated, where new efficiencies or risks may emerge, and how organizations can protect reimbursement performance and sensitive patient information as more data moves through automated workflows.