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Smart Edits

Smart Edits is a claims optimization tool that identifies billing errors within a claim and allows care providers the opportunity to review and repair problematic claims. These courses provide more details on each of the edits.

Featured Course: Smart Edits 101

Discover more about Smart Edits which auto-detects claims with potential errors.  Learn about where Smart Edits are found, the timeframe for responding and how to respond. 

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Smart Edits 101

Smart Edits: Always Therapy

Smart Edits: Clinical Laboratory Improvement Amendments (CLIA)

Smart Edits: Inappropriate Primary Diagnosis Coding (IPDDN)

Smart Edits: Inappropriate Modifier

Smart Edits: Missing Taxonomy Code (Texas Medicaid Only)

Smart Edits: National Drug Code (NDC)

Smart Edits: Non-Covered Supply Code

Smart Edits: Professional/Technical Component Based on Place of Service

Smart Edits: Replacement Code Denials

Smart Edits: Types of Smart Edits