Policies and guidelines hold crucial information for accurate and impactful claims edits, but constantly tracking these updates can drain a health plan’s time and resources. The manual process of finding the right details risks missed insights and inefficiencies, which can affect overall payment integrity and prevent healthcare fraud, waste and abuse.
Watch the video below to see how Shift's Generative AI revolutionizes this process by identifying and analyzing policy, guidelines or other documents to find that critical detail quickly and accurately. With Shift AI, plans can easily identify relevant policy or guideline documents, then extract relevant coding and billing information to generate custom secondary edits with precision, ensuring optimized payment integrity and increased savings.
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Want a deeper dive? Hear more from US Healthcare Lead Data Scientist, Juandiego Marquez on how policy and guideline documents are selected, analyzed and incorporated into an enhanced claims editing and prepay strategy in this webinar snippet.
