July 1, 2021
Premera will be expanding editing on facility claims, including but not limited to acute care facilities. The expansion will include additional edits to help promote correct coding of facility claims. This is in addition to the upcoming enhancement and
expansion of professional claims editing in October 2021.
The edits will assess both current claims and their relationship to historical claims experience in conjunction with the following sources:
Some of the enhanced and expanded edits include but are not limited to the following:
We’ll provide more details as we get closer to implementation.
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