This session explores why 2026 marks the end of black-box Payment Integrity, how neuro-symbolic AI delivers fully auditable decisions with Explainable AI, and how Glass Box Evidence Packs connect every adjudication to the precise policy/contract rationale, reducing provider abrasion and stopping leakage.
 
Key takeaways:
- The Auditability Mandate
- Why 2026 marks the end of “black box” algorithms in Payment Integrity, and how probabilistic outputs are becoming an unacceptable regulatory, compliance, and legal risk.
- Neuro-Symbolic Architecture
- How combining neural models (for document/data extraction) with symbolic logic (for deterministic adjudication rules) delivers the end-to-end auditability required for complex claims decisions.
- From Prediction to Proof
- How “Glass Box” AI produces automated Evidence Packs—linking every adjustment to the exact policy, contract clause, and rationale—to reduce provider abrasion and defensibly stop leakage.