Claims Lifecycle AI API Getting Started

Using artificial intelligence, the Claims Lifecycle AI API proactively identifies Professional claims at risk for denial.

Parsing and evaluating your professional claim information, this cloud service returns a score indicating a claim’s likelihood for denial, lists the top three likely reasons for denial, and insights based on the denial category. Rejection criteria also display a probability score. When you finish editing a claim, you can submit it to the payer using our Professional Claims API.

The Claims Lifecycle AI API works with Professional Claims drafts and with the Legacy Change Healthcare Claims and ERAs in the Change Healthcare Payer List. It accepts Payer IDs that are listed within that clearinghouse. (See http://support.changehealthcare.com/customer-resources/payer-lists, and select Change Healthcare Payer List). Future updates to the Claims Lifecycle AI API will enable the API to be compatible with all clearinghouses in the Change Healthcare system.

Using Claims Lifecycle AI with the Professional Claims API

Because Claims Lifecycle AI API works only with professional claims, you can use the Professional Claims API to submit your claims after AI analysis. However, you are not required to contract for both APIs, although we recommend it. You can also submit your claims in a batch using ConnectCenter (see below).

About ConnectCenter

If you only plan to use a few daily transactions, you may be able to use ConnectCenter for your transaction needs. It performs most of the features supported by an API, but only allows manual entry for all data needed for a transaction. For providers sending hundreds of daily requests, we recommend using APIs because you can automate the submission processes and have a better fit for business needs.

Quick Links

Developer Portal – the home of Change Healthcare’s API documentation.

ConnectCenter Change Healthcare’s portal for Medical Network transactions. It contains Change Healthcare’s Payer Lists, the Payer List Enrollments wizard, and other API customer resources.


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