Session # 1 - Payers & OIG Are Auditing at Scale with AI - Is Your Practice Ready?

Live Webinar Date: June 23, 2026

Time: 01:00 PM ET | 12:00 PM CT

Presented By: R.Sharma, CPC, CPB

When the Algorithm Flags Your Claim — Navigating AI-Driven Payer Audits and OIG Scrutiny in Today's Practice

Somewhere right now, an algorithm is reviewing your claims. Not a human auditor. Not a random spot check. An automated system — scanning patterns, benchmarking your billing against thousands of similar providers, and flagging anything that falls outside what payers consider normal. By the time you receive a letter, the decision is already made.

This is not a future scenario. It is the current reality of practicing medicine in the age of AI-driven payer audits — and the administrative burden it is creating for physician practices is unlike anything seen before.

Payers have made no secret of it. Major national insurers are openly deploying data analytics tools to identify billing discrepancies across provider networks — and the findings are fueling billions of dollars in scrutiny, recoupments, and post-payment reviews. Every claim your practice submits is being measured. Every pattern is being tracked.

At the same time, the OIG continues to expand its active audit initiatives targeting physician billing — with new projects being announced and launched right now. The scope is broad. The risk is real. And most practices have never conducted the kind of internal review that would tell them where their greatest exposure actually is.

Add to this the expanding reach of Medicare Advantage risk adjustment audits — quietly examining whether physician documentation truly supports every submitted diagnosis — and a broader technology shift giving payers direct digital access to practice data, and the picture becomes clear.

The question is not whether your practice is being reviewed. The question is whether your practice is ready.

This webinar gives you the tools to find out — and the knowledge to do something about it.

Webinar Objectives

By the end of this session, you will be able to:

• Understand exactly how AI audit tools work and what claim patterns trigger a review
• Identify which OIG active initiatives are directly targeting physician billing right now
• Recognize where Medicare Advantage documentation most commonly falls short under audit scrutiny
• Conduct an honest internal assessment of your practice's compliance and audit readiness
• Pinpoint the top coding errors and claim patterns that make practices the most vulnerable targets
• Walk away with a clear, practical action plan to close gaps before a payer finds them

Webinar Agenda

• Inside AI-driven payer audits — what they scan, what they flag, and why your practice may already be in scope without knowing it
• The newest physician-focused OIG audit initiatives, what they cover, and how to assess your own exposure honestly
• What RADV auditors examine in physician documentation and the standard most practices are unknowingly missing
• How to assess your compliance posture before a payer, vendor, or OIG review does it for you — and what to fix first
• How new digital infrastructure is giving payers deeper visibility into your practice and feeding the AI engines reviewing your claims
• The documentation and coding patterns — from routine mistakes to experienced-physician blind spots — that consistently open the door to audit
• The claims being targeted most aggressively, the documentation gaps behind them, and immediate fixes that reduce exposure

Webinar Highlights

• Inside the AI audit process — what payers are actually looking for in your claims
• The OIG's newest active initiatives targeting physician billing and how to assess your risk
• Medicare Advantage documentation — the standard auditors apply and where physicians fall short
• A practical framework to assess your own audit readiness today
• The coding errors and patterns that make practices the easiest targets
• Top 10 denied and recouped claim types across multi-specialty practices
• Concrete, immediate steps — no jargon, no theory

Session # 2 - Multi-State Telehealth Updates: Licensing, Compliance & Billing Traps

Live Webinar Date: June 30, 2026

Time: 01:00 PM ET | 12:00 PM CT

Presented By: Chandrika Chandrashekar, CPC, CAIMC, CPMB, FIMC-HCC

Telehealth expansion across state lines sounds simple—but in 2026, it’s one of the biggest compliance and revenue risks in healthcare.

As telehealth regulations tighten in 2026, payers are becoming stricter about credentialing and enrollment accuracy. Many assume that having a license or certification is enough to start practicing telehealth across state lines. In reality, the process is much more complex. Each state has its own licensing rules, payer requirements, and compliance standards. A small mistake can lead to claim denials, delayed payments, or even compliance risks. In this webinar, we will break down telehealth credentialing in a simple and practical way. You will learn how multi-state licensing works, how payer credentialing differs from licensing, and what common mistakes to avoid when expanding telehealth services. This session is designed not just to explain theory, but to give you real-world insights based on payer rules, audit findings, and current 2026 updates. Whether you are a provider, medical coder, or healthcare administrator, this webinar will help you understand how to approach telehealth credentialing with clarity and confidence. By the end of the session, you will have a clear framework to manage multi-state telehealth credentialing efficiently and avoid costly errors. 
 

Learning Outcomes 

By the end of this session, participants will be able to:

1. Clearly distinguish between state licensing, credentialing, and payer enrollment—and understand how each directly impacts reimbursement
2. Navigate multi-state telehealth requirements in 2026 with confidence and compliance
3. Identify exact credentialing gaps that commonly lead to claim denials and delayed payments
4. Apply a step-by-step framework to move from provider licensing to successful payer reimbursement
5. Evaluate interstate compacts (including IMLC) and determine when and how to use them effectively
6. Align telehealth services with payer-specific credentialing and billing expectations
7. Build a scalable strategy for multi-state telehealth expansion without increasing compliance risk

Webinar Agenda

• Telehealth in 2026: Landscape & Compliance Reality
• Licensing vs Credentialing vs Payer Enrollment
• Multi-State Practice: Key Challenges & Hidden Risks
• Interstate Compacts (IMLC) & Licensing Pathways
• Payer Credentialing Requirements for Telehealth
• Common Mistakes That Lead to Denials & Delays
• Building a Scalable Multi-State Expansion Strategy
• Live Q&A Session

Webinar Highlights

• A complete roadmap from license to payment, eliminating confusion across states
• Real-world insights into why telehealth claims get denied—even when providers are licensed
• Practical breakdown of payer credentialing rules most organizations overlook
• Deep dive into 2026 regulatory changes impacting telehealth expansion
• Common audit triggers and compliance risks—and how to avoid them proactively
• Cost vs ROI analysis of multi-state telehealth expansion strategies
• Actionable tips to streamline credentialing workflows and accelerate reimbursements

Who Should Attend

• Medical billing & coding professionals
• RCM teams & billing companies
• Credentialing specialists
• Compliance officers
• Telehealth program managers
• Healthcare providers (Physicians, NPs, PAs)
• Practice managers and administrators
• Telehealth service providers  
• Anyone planning to expand into multi-state telehealth
• Physicians — All Specialties
• Primary Care, Internal Medicine & Family Medicine
• Specialists Seeing Medicare Advantage Patients
• Nurse Practitioners & Physician Assistants
• Medical Coders & Billing Specialists
• Revenue Cycle Managers
• Chief Medical Officers