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From Fragmented to Connected: An End-to-End Approach to Inpatient Medical Expense ManagementFrom Fragmented to Connected: An End-to-End Approach to Inpatient Medical Expense Management
From emergency room to paid claim: A case study in what connected inpatient management actually looks like.
Meet the Speakers
Lalithya Yerramilli
Head of Payment Integrity Solutions
Lalithya Yerramilli
Head of Payment Integrity Solutions
Lalithya Yerramilli is a healthcare technology leader with over 20 years of experience driving innovation at the intersections of analytics, payment integrity, and care optimization. She founded Zigna AI, where she focused on bringing transparency and efficiency to healthcare reimbursement. Previously, she was a member of the executive leadership team at SCIO Health Analytics, leading a global analytics organization and driving growth to support a $1B pipeline. Lalithya holds a master’s in Engineering, Quantitative Finance, and Statistics from Rutgers University, and an undergraduate degree in Engineering from Osmania University.
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Bradley Smertz
Senior Director of Product Strategy and Operations
Bradley Smertz
Senior Director of Product Strategy and Operations
Bradley Smertz is Senior Director of Product Strategy & Operations at Cohere Health, where he leads Cohere's inpatient solution and expansion into other emerging areas across health plan operations. Brad guided the inpatient solution from initial funding through research and development, go-to-market, and client value delivery, helping establish it as one of the fastest-growing parts of Cohere's portfolio.
From Fragmented to Connected: An End-to-End Approach to Inpatient Medical Expense Management
Most health plans manage inpatient costs in fragments. Utilization management (UM) authorizes admissions while payment integrity (PI) manually reviews claims, causing potential savings to be lost. In this 45-minute webinar, experts trace a patient’s journey from emergency room (ER) arrival to final claim payment, revealing where cost control fails and how an integrated, AI-assisted approach closes the gaps. You'll also hear a clinician’s honest account of navigating AI adoption and see a live continued-stay review.
You will walk away with:
- A framework for the five highest-impact inpatient cost levers and why managing them in isolation fails
- A candid look at AI adoption in clinical review–what works and what does not
- A real case study: one diagnosis-related group (DRG) mismatch caught in pre-pay and $5,100 recovered, visible only from UM and PI sharing the same clinical view
- A clear picture of what UM-to-PI connectivity looks like in practice
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