Claim Edits and Analytics
Find fraud, waste, and abuse faster.
At HMS, our Claim Edits and Analytics use the broadest range of pre- and post-pay edits to quickly review claims for error and potential abuse. They’re built on a foundation of investigative findings, federal and state regulations, and then adjusted to reflect your policies.
Our edits create claim-level breakdowns of improper billing issues for instant compliance verification and overpayment protection. The post-pay analytics also target behavior and payment anomalies to find high-risk patterns.
Fill out the contact form to find out more about Claim Edits and Analytics.