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.

Along with Clinical Claim Review, Fraud Solutions, and Prior Authorizations, Claim Edits and Analytics is part of your complete solution for fraud, waste, and abuse.

Fill out the contact form to find out more about Claim Edits and Analytics.

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