EDGE Medical Services Private Network

correction of claim errors

Claim Resolution Services

ON-LINE CORRECTION OF CLAIM ERRORS

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A powerful on-line point and click feature that allows real-time editing of errors identified by the clearinghouse. Immediately after a claim is uploaded, any errors in the claims will be flagged by the claim scrubber. Double-clicking on the error field takes the biller to the error file where each error can be corrected before submitting the charges to the payer. A global “find and replace” feature allows same error that is repeated on several claims (for example, an invalid diagnosis code) to be corrected with a single entry. Some errors may involve two or more fields — for example, accident date occurs before patient birth date — either field could be in error. Both fields are presented in a “point and click” sequence to be edited, so the appropriate field can be corrected. Error messages are “easy to understand” and many indicate exactly what correction is needed.

The security module allows administration to control who can edit claims — as well as the type of edits that each person can make. Audit reports provide a complete audit trail of everything that was done to a claim — who changed specific data and when the change was made.

Other reports show the most common errors that have been made. This helps monitor your staffs’ proficiency and provides training data to reduce future billing errors.

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