claim accuracy

pay claims accurately and reduce costs

Administrative waste, system inefficiencies, billing errors and payment abuse all contribute to a growing healthcare problem. Our solution extends far beyond claim editing to comprehensively address this massive challenge and ultimately increase cost containment.

 

solutions

claims editing

Verscend’s Claim Editing solution integrates with your current claim system to ensure the accurate coding of claims before you pay them. Our more than 17 million nationally sourced and customizable claim edits are applied in real-time or batch to automatically identify claim coding or payment policy violations.

clinical validation

Verscend’s Clinical Validation solution combines technology and expert clinical review services to validate complex claims before payment, further reducing medical costs.

inpatient claim review

Verscend extends clinical review to complex, high-dollar hospital bills with our Inpatient Claim Review services. While these claims may only compose one to two percent of your inpatient claims, they often represent twelve to fifteen percent of your hospital spend.

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