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Streamline facility claims processing
Powerful for both inpatient and outpatient facility claims, our Claims Edit System enables customization by facility, employer and payment methodology. It also integrates with published CMS regulations and guidelines to provide transparency into edit rationale.
Interface across numerous platforms, systems
Our Claims Edit System offers software editing customization to support user-defined rules, contractual reimbursement policies and methodologies. Interface with core adjudication systems, and catch overpayments before an APC/DRG is assigned and payment is rendered.