Divya Verma

Divya Verma, MSHI, RHIA, is a medical necessity and compliance analyst at Solventum. She serves as a subject matter expert in medical necessity edits for Medicare and state programs, supporting healthcare providers in navigating complex regulatory and reimbursement requirements. In her role, Divya collaborates with regulatory agencies, clients, system developers and clinical teams to ensure regulatory policies and clinical requirements are translated into accurate, practical solutions.

She works closely with the Centers for Medicare & Medicaid Services (CMS) and contributes to the ongoing maintenance of National Coverage Determinations (NCDs). She was also part of the original team that translated Medicare NCD policies to ICD-10 for outpatient edits under contract with CMS, as well as the initial ICD-10 translation of Audit Expert inpatient edits.

With over 25 years of experience in healthcare, health information administration, and health informatics, Divya is passionate about improving processes and increasing operational efficiency through innovation. Her recent work explores natural language processing, large language models, and agentic AI to enhance healthcare analytics and streamline workflows.