What’s New With CLIA Smart Edits?

Last modified: August 13, 2020

Smart Edits is a claims optimization tool that identifies potential billing errors and notifies you on your 277CA clearinghouse rejection report. It helps you meet Clinical Laboratory Improvement Amendment (CLIA) requirements and get your claims processed in a timely manner.

Starting Aug. 27, 2020, CLIA Smart Edits will be rejection edits. This means they will not enter UnitedHealthcare’s claims processing system unless the CLIA ID is corrected or added to the claim.

There are three CLIA Smart Edits you may receive if your claim doesn’t meet UnitedHealthcare’s requirements:

  • uMCID – Missing CLIA ID
    • This edit indicates that the CLIA ID was not submitted on the claim for the billing or servicing provider.
  • uIBC – Invalid Billing CLIA ID
    • This edit indicates that the billing provider CLIA ID submitted on the claim was not valid.
  • uISC – Invalid Servicing CLIA ID
    • This edit indicates that the rendering provider CLIA ID submitted in the claim service line detail was not valid.

For more information on how Smart Edits can help you with CLIA claims, please review this self-paced interactive course.