Lyric, which provides healthcare decision intelligence for payment accuracy, today announced that leading health plans are using advanced orchestration capabilities to power intelligent payment recommendations. Delivered through the Lyric42 platform, these capabilities coordinate decisions across rules, workflows, and payment accuracy products.
The announcement marks a significant step in Lyric’s broader strategy to operationalize healthcare decision intelligence, helping health plans make payment decisions that are independent, verified, and explainable, before waste, disputes, and rework move through the system.
Advancing payment accuracy at first pass
Lyric42’s intelligent orchestration capabilities help health plans remove administrative waste and reduce unnecessary provider abrasion by getting payments right the first time.
By improving orchestration across payment workflows, organizations can reduce unnecessary audits and denials, improve payment consistency, and lower administrative costs for both health plans and providers.
“Healthcare payment accuracy requires more than automation alone,” said Halsey Wise, Lyric CEO. “It requires intelligence that is explainable, governed, and aligned to real operational objectives. Lyric’s healthcare decision intelligence augments human decision-making with better coordination, visibility, and evidence so clients can make more confident payment decisions at scale.”
From isolated edits to an intelligent decision layer
Traditional payment integrity systems often evaluate claims through isolated edits or sequential workflow logic. These static architectures process decisions one step at a time, without the ability to reconcile competing signals across the full scope of a health plan’s payment integrity program. The results are fragmented audit workflows, unnecessary provider friction, and payment decisions that are difficult to explain or defend.
Intelligent orchestration within Lyric42 addresses this challenge directly. Rather than processing claims through fixed rules in a predetermined order, the platform dynamically sequences, prioritizes, and reconciles payment decisions in real time, drawing on policy context, historical outcomes, provider impact, reimbursement risk, confidence signals, and client-defined business objectives. The result is payment recommendations that reflect the full picture, not just the next rule in the queue.
“Health plans deserve payment decisions that are coordinated, traceable, and grounded in the full context of their policies and priorities,” said Wise. “Intelligent orchestration within Lyric42 is how we operationalize healthcare decision intelligence, turning fragmented edits and audits into a unified decision layer that works across the health plan enterprise.”
The path from a patient encounter to a paid claim is complex for both plans and providers. This has resulted in many intermediaries and point solutions stacked on top of each other, creating confusion and waste.
“The healthcare system can be chaotic and inefficient,” said Ravi Umarji, Lyric President and CFO. “Lyric42’s orchestration capabilities give health plans clarity and control over critical technology and workflows, allowing for modular configuration, enterprise visibility, and efficiency. This benefits not only the plans but their network providers and the patients they serve.”
Lyric’s approach to healthcare decision intelligence
Healthcare decision intelligence leverages AI, and Lyric applies it deliberately and responsibly within a defined architecture. As a healthcare decision intelligence platform, Lyric42 combines policy, data, responsible AI, deterministic rules, workflow intelligence, and clinical and payment expertise.
“AI is an integral part of the Lyric42 stack, working hand in hand with human knowledge and processes in the middle,” said Yevgeny German, Lyric CTO. “We engineered the platform, so AI operates within a defined architecture, structuring evidence, identifying patterns, optimizing orchestration logic, and surfacing the highest-value actions for review. Every recommendation can be traced to the policy, data, and logic behind it. That transparency is what makes the technology trusted in a healthcare environment.”
Augmenting human decision-making is what makes healthcare decision intelligence different and what makes it vital in healthcare. Governance, clinical and payment expertise, and client control stay central. Health plans see the rationale behind every recommendation and configure business rules, priorities, and review thresholds to match their own policies and operating preferences. Lyric42 is built to inform client decision-making, not replace it.
Together, these capabilities reflect Lyric’s broader evolution. Healthcare decision intelligence improves payment accuracy and redefines traditional audit services as decision intelligence software.
About Lyric
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments. To learn more, visit lyric.ai.
View source version on businesswire.com: https://www.businesswire.com/news/home/20260623117679/en/
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