ACE Smart Edits

Palmetto GBA will soon use data driven pattern detection techniques communicated through smart edits for Part A providers. These edits will appear on claim rejection reports as Palmetto GBA deploys smart edits to the electronic claim submission process for institutional claims. Providers will receive pre-adjudicated, informational only messaging through claim acknowledgement transaction reports (277CA) sent to you, your clearinghouse or your billing vendor. These pattern detection smart edits will assist Part A providers in monitoring specific billing patterns and can serve as a training aide providing detailed provider education for self-auditing purposes.

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