This is a claims optimization tool that identifies claim billing errors and provides the opportunity to review and repair problematic claims. Smart Edits are reported within 24 hours of claim submission so timely adjustments can be made to avoid claim denials.
Smart Edits 101
Learn what the different types of Smart Edits are, what they mean and what actions you can take to respond to them.
Smart Edits detect claims with potential errors within electronic claims and send a message back within 24 hours explaining why. Smart Edits also provide direction on how to resolve for resubmission via the 277CA clearinghouse rejection report.
There are 4 types of Smart Edits that define what specific action is needed from you: Return Edits, Rejection Edits, Documentation Edits and Informational Edits. The message will always begin with P4999, followed by a short combination of letters that identifies the required edit.