Game Changers - Where Money Meets Medicine: A Deep Dive Into Claim Payment

April 17, 2026 | 9:00 am to 9:30 am

In today’s healthcare environment, employers are spending millions on medical claims — yet very few truly understand how those claims are calculated, repriced, or paid. In this Game Changers session, Christina Alonzo, COO for PBA will take us behind the curtain to show exactly what happens from the moment a claim is submitted to the moment it’s paid — revealing the mechanics, the math, and the hidden opportunities for savings.

• How medical claims really get priced and paid — from billed charges to allowable amounts, discounts, audits, and final payment.
• How TPAs uncover hidden savings through advanced repricing, clinical review, and payment integrity strategies.
• Real world examples of claim errors, overpayments, and recoveries that demonstrate where dollars are slipping through the cracks
• What a “clean claim” looks like versus one that requires repricing, clinical review, or stop loss intervention — and why it matters