Ripunjaya Pattnaik

This book takes readers inside a new era of intelligent healthcare systems, showing how AGENTIC AI FOR
Healthcare PAYORS can reimagine the core functions of payor organizations. Instead of relying on static automation, agent-based models think, act, and adapt in real time. Claims adjudication, compliance checks, and operational workflows become smarter, faster, and more resilient. The goal is to help payors move beyond manual processes and embrace scalable, high trust decision making.

Its impact reaches far beyond the technical layer, touching member experience, provider relationships, and financial stability. Agentic AI enhances fraud detection, reduces administrative burden, and brings consistency to complex policies. Practical scenarios, architectural models, and real deployment insights give both executives and engineers a clear path to implementation. In every chapter, the book demonstrates how healthcare payors can transform not just their systems, but the quality of service they deliver.