Improve SIU efficiency, case identification and recoveries with unprecedented insight into the risk tied to providers, members, and claims interactions across your health plan. LexisNexis pre- and post-pay solutions combine and utilize the most complete, current, and comprehensive provider, member, and public records data sources in addition to a clients’ claims data for clarity into identities and billing behaviors. Our solutions deploy rules across various claims types, layering scoring analytics and predictive modeling for better case selection and triaging; and incorporate linking capabilities to disparate data sources to resolve identities and uncover hidden relationships that would otherwise go undetected.
Product Categories
- NHCAA Bingo