Podcast Summary: From Friction to Collaboration—The Future of Payment Integrity
Becker’s Healthcare Podcast – December 10, 2025
Guest: Brian Berkowitz, Chief Product Officer, Lyric
Host: Lucas Voss
Episode Overview
This episode explores the escalating challenges and emerging solutions for payment integrity in healthcare. Brian Berkowitz of Lyric shares insights on how technological advances, particularly in AI and blockchain, are transforming a traditionally adversarial process into one focused on trust, transparency, and collaboration between payers and providers. Key themes include the concept of “trusted intelligence zones,” the potential to reduce administrative burden, and predictions for the evolution of healthcare data integrity in 2026 and beyond.
Key Discussion Points & Insights
1. The Current Payment Integrity Landscape
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Theme: The healthcare landscape is marked by mistrust, competition, and fragmentation in the payment process.
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Brian compares the current environment to “an arms race,” with both health plans and providers rapidly deploying AI solutions to outmaneuver each other, resulting in increased silos rather than collaboration.
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Quote:
"If we look back at history, most arms races at their core are fueled by a lack of trust."
— Brian Berkowitz [02:31] -
Both sides worry about being disadvantaged, leading to duplicated systems, fragmented models of truth, and worsened administrative burdens.
2. The Need for Trust and Systemness
- System Fragmentation: Proliferation of proprietary AI tools exacerbates fragmentation, undermining trust and alignment.
- Impact:
- Duplicated work
- Increased administrative overhead
- Distracting from the core mission: delivering better and more affordable care
- Brian suggests technology is now mature enough to “create trust by design,” utilizing AI, blockchain, and privacy technologies.
3. Trusted Intelligence Zones (TIZ)
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Definition: A secure, neutral digital environment where payers and providers can access the same, validated insights in real time, without giving up control of their proprietary data.
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Key Features:
- AI-driven mediation
- Blockchain accountability
- Privacy-centric governance
- Transparency and verifiability of every decision
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Quote:
"Almost think of it as a digital trust fabric where instead of both sides sending files and data back and forth and debating whose data is right ... everyone's getting to see the same validated insights in real time."
— Brian Berkowitz [05:08] -
Goal: Build fairness and traceability into the architecture of payment integrity systems, moving from adversarial audits to collaboration.
4. AI’s Role in Payment Integrity and Administrative Burden
- Traditional Approach: Retrospective, manual audits detecting payment errors after the fact—inefficient and tension-laden.
- Modern Shift:
- AI enables proactive detection, flagging issues earlier, often at the point of care.
- Reduces need for audits and appeals, lowering friction while improving transparency and education.
- Quote:
"We're shifting towards more of a world where we can detect more before the issue even happens and get it to happen even closer to the point of care ... reducing a lot of the administrative back and forth."
— Brian Berkowitz [07:14] - Outcome: Fewer manual processes, greater consistency in outcomes, and human focus redirected to the most complex issues.
5. Building Alignment for a Collaborative Future
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Alignment & Data Accuracy: As healthcare becomes more data-driven, alignment between payers and providers is crucial for scale.
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2026 Predictions:
- Convergence of policy (data liquidity/interoperability), widespread provider adoption of AI, and increasing consumer/employer demand for transparency.
- Regulatory push makes standardized data sharing a requirement.
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Quote:
"2026 is shaping up to me to be a big year for healthcare ... these trends are going to push for a lot more required collaboration across the ecosystem."
— Brian Berkowitz [09:54] -
Data Collaboration: Essential for building shared intelligence and solving the trust challenge.
Notable Quotes & Memorable Moments
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On AI arms race:
"Each side is starting to build their own tools, they're using their own data models, and they're really defining their own definition of truth, which instead of building bridges ... is really starting to build more silos ... fueling even more mistrust."
— Brian Berkowitz [02:31] -
On the North Star for Lyric:
"Accuracy to us builds alignment and alignment is really what's required to get trust. And when trust exists, simplicity really follows from that."
— Brian Berkowitz [00:33] -
On the next chapter for healthcare tech:
"We spent years building automation that is fast, efficient and scalable. But this next chapter is all going to be about what's accountable, explainable, and fair."
— Brian Berkowitz [12:17]
Timestamps for Important Segments
- 00:00–00:33 – Introductions & Brian’s background
- 01:57 – Trust as the foundation for payment integrity
- 02:31–04:48 – AI adoption as an arms race and its unintended consequences
- 05:08–06:44 – Introduction and explanation of “trusted intelligence zones”
- 07:14–09:14 – How AI reduces administrative burden and creates equitable payment outcomes
- 09:54–11:59 – 2026 outlook: collaboration, regulatory trends, and data liquidity
- 12:17–13:08 – Closing thoughts on trust, safety, and the future of accountability in healthcare
Conclusion
Brian Berkowitz makes a compelling case for shifting the payment integrity paradigm from one of mistrust and friction to a future grounded in technological trust, shared data intelligence, and system-wide collaboration. As AI and interoperability become requirements, he stresses that sustainable innovation will depend on building fairness, transparency, and, above all, trust into every transaction and relationship within healthcare.
“The true leaders aren't going to be the ones with the flashiest AI tools. They're going to be the ones who are really designing their ecosystems to have that trust and accountability into what they're doing.”
— Brian Berkowitz [12:17]