{"type":"video","version":"1.0","html":"<iframe src=\"https://www.loom.com/embed/9872a4d6d2bb432e8f12fc0651108f04\" frameborder=\"0\" width=\"1670\" height=\"1252\" webkitallowfullscreen mozallowfullscreen allowfullscreen></iframe>","height":1252,"width":1670,"provider_name":"Loom","provider_url":"https://www.loom.com","thumbnail_height":1252,"thumbnail_width":1670,"thumbnail_url":"https://cdn.loom.com/sessions/thumbnails/9872a4d6d2bb432e8f12fc0651108f04-2e0888dca25ea0ca.gif","duration":75.392,"title":"Automated 837 Claim Risk Scoring Queue","description":"This Loom explains how an application processes healthcare 837 claim files to predict denial risk. It notes that 15 to 20 percent of claims are denied, with 65 percent tied to eligibility, authorization, or coding issues. The system uploads and parses the 837 file, uses a rules engine to produce a risk score from 0 to 4 based on factors like NCI conflicts, missing authorization, diagnosed procedure mismatch, and documentation gaps. It then validates claims into queues with scores such as 86, 90, 91, and 35."}