Traditional revenue cycle automation can streamline tasks but often stops short of true transformation. The next frontier is agentic AI — autonomous, goal-driven systems that make decisions, act independently, and continuously improve outcomes. This session explores how agentic AI can reshape RCM into a proactive, self-optimizing function. Through real-world examples, we will examine its role in coding, prior authorization, denial prevention, and patient engagement, highlighting measurable gains in accuracy, speed, and financial performance. Attendees will learn how to distinguish agentic AI from traditional AI, as well as how to structure governance and workflows that balance autonomy with compliance and human oversight. The session will also address how to track ROI using metrics such as gross collection rate (GCR), days in A/R, and cost-to-collect.  

Artificial intelligence is reshaping healthcare, from clinical decision support to administrative automation. As vendors flood the market with AI-enabled tools, medical groups face new challenges: how to responsibly evaluate opportunities, avoid compliance missteps, and prepare for emerging regulation. This session explores the intersection of AI, compliance, and governance in healthcare organizations. Topics include the current regulatory landscape, state-level AI legislation, and evolving federal agency guidance. The speakers will address practical questions for practice leaders: What due diligence is needed before adopting an AI tool? How do you manage risk when AI is used for sensitive functions such as billing, documentation, or patient engagement? What governance structures (committees, policies, and accountability frameworks) should be in place to oversee AI adoption? Michelle Wright, EBG Advisor and former payer executive, will engage Kathleen Premo, EBG Partner and former General Counsel/Chief Legal Officer, and Rachel Snyder Good, EBG Strategic Counsel, to provide operational and legal perspectives. Attendees will leave with a roadmap to balance innovation with compliance, positioning their practices to leverage AI while protecting their organizations. 

Enforcement agencies are not slowing down when it comes to investigations, settlements, and legal actions related to noncompliant coding and billing in medical practices. Using a case‐study approach, this session will highlight recent enforcement actions and the lessons they reveal across key risk areas in coding and/or billing. Where available, case studies will draw from court documents to shine a light on details not typically included in enforcement press releases or news coverage. Topics will include medical necessity, coding modifiers, E/M services, "incident‐to" scenarios, and more. Attendees will leave with a clearer understanding of current enforcement priorities and practical insights to strengthen this compliance programs and reduce exposure.

Your practice is the subject of a government audit. Now what? Audits and investigations are a fact of life for medical groups, but few leaders are fully prepared when the notice comes. Medicare, Medicaid, and commercial payers are expanding oversight, and even small coding errors, documentation gaps, or compliance missteps can quickly escalate into serious risk. The impact goes far beyond dollars. Financial penalties are significant, but reputational harm, regulatory scrutiny, and loss of trust can be just as damaging. How you respond — and how quickly you engage the right support — often determines whether the outcome is manageable or catastrophic. This session offers a candid discussion of the hard truths and critical lessons in responding to coding and regulatory issues. Attendees will gain insight into the types of audits most common in fee-for-service and government payment programs, the risks associated with each, and what investigators are really looking for. Participants will walk through a vignette that traces the response to an audit notice — from initial letter through risk mitigation — to help leaders be better prepared. In an interactive style format, the speakers will provide strategic and hands-on guidance for practice leaders.