Claim Alter For Free

Billing edits are maintained within the organization's billing system and are applied prior to the claim being staged to the bill scrubber.Similar to a bill scrubber, a clearinghouse scrubs the claim according to specific payer/carrier requirements to ensure the claim is appropriate and accurate for submission.

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Legal doctrine whereby the court finds a corporation lacks a separate identity from an individual or corporate shareholder, resulting in injustice to the corporation's debtors.

While there are universal or standard claim edits such as National Correct Coding Initiative (NCCI) Edits, Global Edits, and Correct Coding or ICD-10-CM Edits, these types of edits do not cover all requirements for large medical groups.

ClaimsXten identifies the same code billed twice for the same date of service, where the first code has the bilateral modifier appended. This rule denies the second submission of the procedure code in question regardless of whether it is submitted with or without a bilateral modifier.

CMS uses claims coding edits to prevent overpayment or inappropriate reimbursement of Part B fee schedule services. For the physician fee schedule, there are two basic types of code edits: the Correct Coding Initiative (CCI) and the Medically Unlikely Edits (MUEs).

Claims editing is a step in the claims payment cycle that involves verifying that physician-submitted bills are coded correctly.Claims editing is a step in the claims payment cycle that involves verifying that physician-submitted bills are coded correctly.