Our Smart Edits claims tool catches errors and gives you an opportunity to resolve and resubmit a claim before it enters the claims cycle — so you can get paid faster. Within 24 hours of submission, Smart Edits triggers a notification that clearly identifies the error, keeping you one step ahead of potential claims issues. Once notified of the error, you'll have five days to make changes and resubmit the claim.
If you submit claims for eligible Payer ID numbers, you may already get Smart Edits on your 277CA clearinghouse reject report. Eligible Payer ID numbers include: 87726, 03432 (AZ); 96385 (KS); 95467 (Ml); 86050 (MO); 86047 (NJ); 95378 (TN); 78857, 65088, LIFE1 and 36273.
For more information on how Smart Edits could speed up your claims cycle, visit UHCprovider.com/smartedits.
Check your 277CA report and look for a Smart Edits notification. If you aren't receiving edit notifications, contact your software vendor. The message will explain why the claim was returned and provide direction on how to correct the claim for re-submission. Refer to the Smart Edits Guide for more information.
Review and modify the claim by responding to the edit message on the 277CA clearinghouse reject report within five days to minimize potential rework or denials. The more accurate the claim, the faster it can be approved and the quicker you'll be paid for the services you deliver. A Smart Edit will carry the resubmission date, not the original date of claim submission.
For more information about Smart Edits, contact the EDI Support Team at firstname.lastname@example.org or call 800-842-1109.