Agree on pre-adjudication approach and technology
How agree on pre-adjudication approach and technology are reshaped as AGI capability advances.
Business-as-Code
Read as an executable program — the work decomposed into Code, Generative, Agentic, and Human.
Agree on pre-adjudication approach and technology sits inside a larger value-flow — 1 parent structure it composes into. The hierarchy is grounding, not the story: it tells you which aggregate exposure Agree on pre-adjudication approach and technology inherits.
Where Agree on pre-adjudication approach and technology sits
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How the work flows
Trigger: A strategic initiative, system migration, or high downstream denial rate necessitates a new or updated front-end claims scrubbing strategy.
- Evaluate current claims intake and front-end scrubbing capabilities
- Identify gaps in eligibility verification and coding edits
- Assess potential technology solutions and rules engines
- Define the required business rules and EDI edit parameters
- Align IT and claims operations stakeholders on the proposed technology
- Finalize and document the agreed-upon pre-adjudication architecture
Outcome: A formalized pre-adjudication strategy, including the selected technology stack and business rule framework, is approved for implementation.