What you’ll learn
- Why most health plans treat A&G as a cost center—and why that needs to change
- How to automate audit readiness and reduce manual effort by up to 40%
- The operational and member experience value of root-cause analytics
- How GenAI and built-in compliance logic are transforming A&G case management
- Real-world outcomes from leading plans: fewer repeat grievances, faster audits, improved SLA performance
Who should read this?
- A&G and Compliance leaders
- Health plan Operations and CX teams
- Medicare, Medicaid, and Commercial plan executives
- Digital transformation, audit, and regulatory strategy stakeholders
Why this matters
Most payer organizations still rely on manual systems, disconnected workflows, and reactive audit prep. This leads to high operational costs, CMS risks, and missed opportunities to improve member experience.
This ebook walks you through the shift—from ticket tracking to proactive intelligence—so your team can stop chasing issues and start driving change.