HealthEdge Source™: Advanced Custom Edits

HealthEdge Source now offers a robust Advanced Custom Editing feature, empowering clients to create and manage custom edits directly within the user interface. This innovative tool provides granular control over claim editing, allowing for the creation of complex, history-based edits with ease. By leveraging a user-friendly interface and flexible configuration options, clients can efficiently tailor editing rules to specific business needs, improving claim accuracy and reducing costs.

Key features of Advanced Custom Edits include:

Create custom edits with detailed criteria, including claim header, claim line, edit ID, disposition, provider types, and custom messages.
Utilize a variety of claim fields and groups for complex edit conditions, including CMS 1500, UB04, Service Group, and user-defined fields.
Apply edit history to evaluate member claims based on specific timeframes and service criteria.
Configure comparison criteria for historical data using less than or greater than functionalities.
Implement edits immediately upon creation and easily update them as needed.

This feature is licensable and offers granular permissions to control user access, ensuring data security and compliance.

By providing unparalleled flexibility and control over the claims editing process, HealthEdge Source Advanced Custom Editing is a game-changer for healthcare payers seeking to optimize payment integrity and operational efficiency