Medical Network Claims Lifecycle AI v2
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Using artificial intelligence, the Claims Lifecycle AI API proactively identifies claims at risk for denial.
Using professional claim information, this service returns a score indicating a claim’s likelihood for denial, lists the top three likely reasons for denial, and insights based on the denial category. Rejection criteria also display a probability score. When you finish editing a claim, you can submit it to the payer using our Professional Claims API.
The Claims Lifecycle AI API works with Professional Claims drafts and with the Legacy Change Healthcare Claims and ERAs in the Change Healthcare Payer List. It accepts Payer IDs that are listed within that clearinghouse. (See http://support.changehealthcare.com/customer-resources/payer-lists, and select Change Healthcare Payer List). Future updates to the Claims Lifecycle AI API will enable the API to be compatible with all clearinghouses in the Change Healthcare system.
Most of our APIs are private and require credentials to gain access. Begin by obtaining your
You can test the APIs from within our interactive documentation (see the API page), use an application such as Postman, or use your own development platform.
The goal for onboarding is to ensure API customers can automate their API consumption process. For end use, API consumption shouldn't require 'seeing' the APIs; preferably, a number of tasks can be automated:
For token automation, you can apply one of the following:
The endpoints for the Eligibility API collection are as follows.
You submit the claim using your standard workflow or use another Change Healthcare API to do so.
Using the API
In our interactive documentation, select the API tab, and select the green POST API object. Scroll down to the Authorization field, enter the word Bearer, and paste your token into the Bearer Token field.
If you are using our Postman collection or a similar development console, ensure your
For Sandbox and production API testing, you can also edit the request body. Don't use real-world values in Sandbox API usage. Doing so will produce errors.
For Sandbox usage, we also provide predefined values to simulate Personal Medical Information (PMI) in the Sandbox environment. For successful use of Sandbox APIs, you must use these "fake patient" values for your testing. Check the FAQ page section Sandbox predefined fields and values for more information.
For further details about Claims Lifecycle AI API usage, see the FAQ page.