Automated Adjudication Logic and Denial Pattern Intelligence: Machine Learning Models for Health Insurance Claims Processing Optimisation
Keywords:
automated adjudication logic, denial pattern intelligence, machine learning models, health insurance claims processing optimisationAbstract
Health insurance claims processing partners insurers with healthcare providers to ensure quick and efficient financial management of patient care. Dealing with the complexity and number of claims filed by large hospital systems is important in sustaining those healthcare providers financially. Providers authorize procedures and document patient encounters, then submit claims to payers for reimbursement.Readership Data
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