Smart Edits to include behavioral health, starting June 2021

Last modified: May 11, 2021

Starting June 2021, Smart Edits will be active for behavioral health care professionals to help repair claims with potential errors. When claims are submitted accurately and in compliance with the latest policies and regulations, it results in less rework, quicker approvals and faster payments.

What are Smart Edits?

Smart Edits is a claims optimization tool that identifies billing errors within a claim and allows you to review and repair problematic claims. Smart Edits are sent within 24 hours of a claim submission, so you can review identified claims in a matter of hours instead of potential claims denials days later. Smart Edits has continually evolved to include more payer IDs each year.

How does it work?

If the information within your claim triggers a Smart Edit, you will see a message on your 277CA clearinghouse rejection report within 24 hours of submission. A Smart Edit message will explain why the claim was returned and provides direction on how to update and resubmit the claim, or let you know if any future action is needed.

Questions?

We’re here to help you navigate this new tool. Please review the self-paced interactive guide or reach out to EDI Support at 800-842-1109 or SupportEDI@uhc.com for the latest information and updates.