Using artificial intelligence, the Claims Lifecycle AI API proactively identifies Professional claims that are at risk for denial.
Using the professional claim information, this service returns a score indicating a claim’s likelihood for denial, lists the top three likely reasons for denial, and more 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.