Data Sheet: Optimize Payment Accuracy with History-Based Editing
As more contracts and policies shift toward value-based care and billing requirements, evolve, the opportunities for inaccurate payments increase...
Optimize Payment Accuracy with History-Based Editing
As more contracts and policies shift toward value-based care and billing requirements, evolve, the opportunities for inaccurate payments increase. History-based editing emerges as a powerful solution, enabling payers to identify inaccuracies through historical claims data. Despite the potential cost savings, implementing these standards across disparate systems can be challenging and costly for many payers.
Health plans using history-based editing report an average savings of 20% per impacted claim. This approach not only reduces costs but also minimizes provider abrasion through consistent application of accepted content. HealthEdge Source™ (Source) history-based Medicare edits span various specialties, including Professional, HHA, ESRD, FQHC, Suppliers, ASC, HOPD, SNF, Hospice, CAC, LTCH, Inpatient, IRF, and ambulance services.
By licensing the module through Source, the entire process is automated. It identifies claims over the past 39 months affected by current claims and returns accurate claim amounts prior to payment. This reduces downstream effort and ensures historical data is fully leveraged.
For more information on Source's History-Based Editing capability, please visit the Source Editing solution page on the HealthEdge website.
