Payers depend on numerous administrative codes and medical terminologies to process payments. When these code sets are updated by standards bodies, payers must accurately incorporate these updates in a timely manner—and keep them relevant to the rules already established within the processing system. The Language Engine makes the updating process fast and easy.

Government:

  Regulatory compliance of billing and reimbursement processes is affected by frequent updates to claim edits and code sets, updates that can take significant time. Auditing methodology and rationale of these changes is required for compliance. HLI technology documents the methods and user rationale for all changes.

Health Plans:

  Updating administrative code sets demands time and resources and, when not performed correctly, increases time required for claims processing. Keeping data accurate and consistent over time is critical to identifying predictive indicators for improved patient care. The LE solution can streamline content updates and ensure accuracy and timeliness of data.

Insurance Carriers:

  Synchronizing updates of multiple systems in multiple locations requires time and coordination. Providing a central source for all administrative code and medical terminology updates simplifies the process and reduces the cost of maintaining controlled vocabularies. The LE solution enables centralized update and distribution of content.