Voices of Self Funding: How AI Agents are Transforming Payment Integrity

Host Tom Testa sits down with Angel Onuoha, co-founder and CEO of Avelis Health, for a deep dive into how AI agents are reshaping payment integrity, claims auditing, and healthcare cost management.Inspired by his own experience navigating inflated medical bills after multiple knee surgeries, Angel set out to tackle one of healthcare’s biggest hidden problems: payment errors and billing complexity. The conversation explores how Avelis is using AI agents to transform summary plan documents into auditable claim rules, identify overpayments in real time, and even deploy voice AI to communicate directly with providers about denied or recouped claims.Angel also unpacks why generic large language models can be dangerous in healthcare workflows, the importance of explainability and auditability in AI systems, and how organizations must rethink PHI security, access controls, and trust when deploying AI at scale. Angel shares his perspective on why today’s payment integrity ecosystem suffers from misaligned incentives — and why AI may finally give TPAs and self-funded employers the tools to proactively reduce waste without adding administrative burden.If you want to understand where AI in healthcare is moving beyond hype and into real operational impact, this is a conversation you won’t want to miss.This episode is sponsored by zakipoint Health. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/