There’s no question that automated claim editing is a crucial component of accurate and efficient claims payment. Using black-and-white sourced edits from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association’s (AMA) CPT® book, as well as payer-sourced custom rules, these systems save plans a significant amount of money by keeping them from paying incorrect claims without human intervention.
But is having one automated claim editing system enough to ensure total claim accuracy, or are you leaving significant savings on the table without a secondary editor? And if you already have a secondary editor, is there a benefit to adding a tertiary editor? Here are three fast facts you should know about how far automated claims editors can go.... Read More