AI and Algorithms: An Effective Approach to Medical Claims Processing
AIHC
MAY 30, 2024
AI-Powered Challenges Historically, rule-based algorithms for coding and claim adjustments (also known as coding-related edits) were created to streamline the claims adjudication and payment procedure for providers sending medical bills to payers. Opportunity: One or more edits caused the entire claim to be rejected 1.2
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