ClaimRite™ is a batch process that validates that claims contain valid CPT and ICD-9 codes and that procedures pass the active Medicare and commercial rules/edits. It helps providers to expedite the billing process.
- Provides reports detailing why an item failed for LCD, NCD or CCI edits
- Identifies items that do have an accepted, signed ABN in OrderChecker™
Additional available modules, all customized to fit your specifications, include:
- Claim Scrubber Module, which can automatically apply GZ or GA modifiers to a claim displaying when an ABN is and is not present
- Stand-Alone Report Module, which provides a detailed failure report including edit failures by patient, demographic information and claim specific criteria (CPT Code/Description, CPT Modifiers, ICD Codes, DOS, Non-Covered Charges, Type of Failure, ABN status)
- Claims Extractor Module, which translates one claim file into two – one clean and ready to be submitted and the other containing patient accounts with at least one medical necessity or CCI edit failure so that staff can rework.
Depending on the level of customization, some or all of these modules may be needed to achieve the desired outcome.
ClaimRite™ (previously known as PCA) is part of the Passport eCare™ Orders Suite and was developed by Healthworks, Passport Health Communications' Clinical Orders division.
ClaimRite™ and ensure Payment Certainty with Clean Claims!