Lyric made expert review generally available in Lyric42, letting health plans hold selected claims during adjudication for a targeted review by an expert. Lyric42 finds and ranks the claims under criteria the plan sets, routes each to the right reviewer and returns a recommendation, while the plan makes the final call. Coding Review, which covers complex modifier use and procedure relationships, is the first review type and is available now.
Our readPlans get a human check inside the prepayment flow without sending claims to a separate vendor. Lyric says review outcomes feed back into new prepayment edits, so ask how those rules are approved before they go live.