Concepedia

Claims Validation

Claims Validation is a methodological process in medical claims processing that verifies the accuracy, completeness, and compliance of submitted claims with established regulatory, contractual, and coding standards to determine their eligibility for adjudication.

8

Publications

808

Citations

61

Authors

25

Institutions

Publications per year

2017–2026

3

Parents

Publications

8

Validation of diagnostic codes within medical services claims

Machelle Wilchesky, Robyn Tamblyn, Allen Huang · Journal of Clinical Epidemiology · 2004 · 443 citations

, , +13

An Administrative Claims Model for Profiling Hospital 30-Day Mortality Rates for Pneumonia Patients

Dale W. Bratzler, Sharon‐Lise T. Normand, Yun Wang et al. · PLoS ONE · 2011 · 120 citations · Full text

, , +17

Validation of an algorithm for identifying MS cases in administrative health claims datasets

William J. Culpepper, Ruth Ann Marrie, Annette Langer‐Gould et al. · Neurology · 2019 · 108 citations · Full text

, , +13

External validation of a claims-based algorithm for classifying kidney-cancer surgeries

David C. Miller, Christopher S. Saigal, Joan L. Warren et al. · BMC Health Services Research · 2009 · 58 citations · Full text

, , +16

Using ‘big data’ to validate claims made in the pharmaceutical approval process

Thomas Wasser, Kevin Haynes, John Barron et al. · Journal of Medical Economics · 2015 · 28 citations · Full text

, , +17

1–5 of 8

Authors

61

  1. SH
    Sandra Hischke

    Universität Hamburg, Germany

    1 publications · 12 citations

    1

    h-index

  2. JH
    J. Hanley

    Michigan Center for Translational Pathology, United States

    1 publications · 58 citations

    1

    h-index

  3. TS
    Thea Schwaneberg

    University Medical Center Hamburg-Eppendorf, Germany

    1 publications · 12 citations

    1

    h-index

  4. LW
    Laurie Wagner

    McKing Consulting (United States), United States

    1 publications · 108 citations

    1

    h-index

  5. CZ
    Chaoyuan Zuo

    Stony Brook University, United States

    1 publications · 19 citations

    1

    h-index

1–5 of 61

Institutions

25

  1. Wilmington University

    New Castle, United States

    2 h-index

    6 publications

    152 citations

  2. National Cancer Institute

    Bethesda, United States

    1 h-index

    1 publications

    58 citations

  3. McGill University

    Montreal, Canada

    1 h-index

    3 publications

    1.3K citations

  4. RAND Corporation

    Santa Monica, United States

    1 h-index

    4 publications

    232 citations

  5. Oklahoma Foundation for Medical Quality

    Oklahoma City, United States

    1 h-index

    1 publications

    120 citations

  6. Yale University

    New Haven, United States

    1 h-index

    2 publications

    240 citations

  7. Massachusetts General Hospital

    Boston, United States

    1 h-index

    1 publications

    120 citations

  8. Michigan Center for Translational Pathology

    Ann Arbor, United States

    1 h-index

    1 publications

    58 citations

1–8 of 25

Venues

  1. Thrombosis and Haemostasis

    1 publications · 20 citations

    1

    h-index

  2. Das Gesundheitswesen

    1 publications · 12 citations

    1

    h-index

  3. Neurology

    1 publications · 108 citations

    1

    h-index

  4. Journal of Medical Economics

    JME · 1 publications · 28 citations

    1

    h-index

  5. Journal of Clinical Epidemiology

    1 publications · 443 citations

    1

    h-index

1–5