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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Coordination of Benefits (COB) Smart Edit


Duplicate Claim Smart Edit


Modifier 25 Smart Edit


Smart Edits 101


Smart Edits: Always Therapy


Smart Edits: Bundling/Unbundling Smart Edits


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 Codes 


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


Smart Edits: Replacement Code Denials


Smart Edits: Types of Smart Edits


Vitamin D Smart Edits


Workers Comp Smart Edit