What's the difference between this API and the Claims Lifecycle AI API?

The Claims Lifecycle AI API flags claims based on the volume of all claims of particular types that Change Healthcare observes in its API data flows. Using machine learning, it detects discrepancies and gives a percentage likelihood for denial of a claim.

Integrated Rules does not use machine learning; it relies on lengthy Rule/Edit collections for many medical specialties to validate your claims based on each discipline encompassed by your chosen Knowledge Packs. Consider Claims Lifecycle AI API to be a complementary API for grooming and claim scrubbing. It is also usable for both Institutional claims and Professional claims.


Did this page help you?