From the Trenches: A Healthcare Analytics Podcast

From the Trenches: A Healthcare Analytics Podcast


Episode 07 - Validating clinical claims without medical record review

May 08, 2018

Automated claim editing systems are a crucial component of accurate and efficient claims payment. But there will always be claims that are too complex to be auto-adjudicated and need a human touch. So, what exactly do you need to clinically validate a claim? We talk with Kris Jensen, registered nurse and clinical consultant for Cotiviti's Payment Accuracy solutions.