Smart Claims Engine provides a framework for performing basic validations before the claim goes through benefit and pricing adjudication. These validations support the claim-header and claim-line level edits for professional, institutional and dental claims. These validation edits are performed in the Process validation edits (SVE) module.

To add more validation edits, you would add a new collection containing edits to the Pre or Post steps of the SVE module.

• Data sources for validations
• Validation edit event codes
• Code group assignment
• Guided event resolution for validation events

• Claim pre-adjudication