ACE Smart Edits

Palmetto GBA will soon use data driven pattern detection techniques communicated through smart edits for Home Health and Hospice 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 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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