Identifying Missing Claims to Improve Data Quality and Health Plan Operations

December 11, 2025

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One of the nation's largest health plans needed to validate the data they were receiving from their customers was accurate and complete due to the potential negative impact it could have on operations across its organization from financial management to member services.

See how Certilytics' first-of-its-kind ClaimsGPT model helped predict missing claims and identify denied claims not being submitted - resulting in improved data quality and accuracy for the plan.