Serving as a health plan's first line of defense against improper payments, claim edits are vital for ensuring payment accuracy and cost savings. These edits are based on national, state, or plan-specific standards, policies, and guidelines, and their effectiveness depends on staying updated with this constantly evolving landscape—that’s no simple feat.
In this clip from a recent Shift webinar on enhancing prepayment strategies, Shift Healthcare Data Scientist Juandiego Marquez discusses how to enhance claim edits using GenAI.
Enjoy the clip? View the full webinar here.