Payer policy

In healthcare, a payer policy outlines the rules and guidelines established by insurance companies and other third-party payers regarding medical services, treatments, and medications they will cover. These policies dictate everything from prior authorization requirements to specific coding guidelines, directly impacting claim approvals and reimbursement rates. Nym’s autonomous medical coding solution helps healthcare providers navigate complex payer policies by ensuring accurate and compliant coding, leading to optimized revenue cycles and reduced claim denials.