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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
Published:
April 21, 2026
Most health plans still manage inpatient costs in fragments, creating blind spots that drive avoidable spend. Admissions are authorized in utilization management (UM), while payment integrity (PI) teams manually review claims downstream, leaving critical savings opportunities on the table. In this on‑demand webinar, you will see a full case walkthrough that exposes where cost control breaks down and how an integrated, AI‑supported approach closes the gaps.
Our experts trace a patient’s journey from ER arrival through final claim payment, highlighting the operational and clinical friction points that emerge when UM and PI work in isolation. You will also hear a clinician’s candid perspective on adopting AI in review workflows and watch a live continued‑stay review that illustrates the impact of shared clinical context.
Meet the Speakers
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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.
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.
Ragen Coombs
Senior Clinical Research Specialist
Ragen Coombs
Senior Clinical Research Specialist
Ragen Coombs is a registered nurse with 22 years of experience, including 14 years specializing in Utilization Review and Management across both payor and provider settings. At Cohere Health, she serves on the Clinical Intelligence team as an Inpatient Clinical Research Specialist, where she supports the development, training, testing, and auditing of AI‑driven clinical features.
In this on‑demand webinar, you will learn:
- The highest impact inpatient cost levers and why managing them separately leads to missed savings
- What clinicians say about AI adoption in review processes, including what works and what falls short
- 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
- What true UM to PI connectivity looks like in practice and how it transforms accuracy, speed, and collaboration
Access the recording to explore the full case study and take away practical insights your teams can apply immediately.
