UnitedHealthcare implements Smart Edits into the EDI claim process In the April 2018 UnitedHealthcare (UHC) network bulletin, UHC notified physicians that it would implement Smart Edits, a new functionality introduced into the EDI workflow, allowing the payor to autodetect claims with potential errors in the claims pre-adjudication phase. Once a potential error has been identified, UHC will notify the physician (via the 277CA report) within 24 hours, returning the claim to the provider along with a suggested modification to overcome the problem. Providers will have five calendar days to correct the claim and resubmit it, reducing the potential ... June 14, 2018 United Healthcare claims, edits, uhc 0 0 Comment Read More »
