Claims Batch Editor Add-on

Optum



500.00
List Price Per User

Item #: WA16
Available: NOW

In order to add this item to your cart, you must first add a qualifying item to your cart. See the list of qualifying items in the 'Description' tab below.


Watch the add-on modules product video.

The Claims Batch Editor Add-on, only available for EncoderPro.com Expert and EncoderPro.com for Payers, is a sophisticated and easy-to-use claims review tool for physician claims. Using proven coding rules and logic from Optum360 ClaimsManager, the Claims Batch Editor Add-on is designed to work within the customer's current workflow to identify inappropriately coded physician claims before they are submitted to payers, assisting with first pass payment. 

This includes commercial, Medicare and even state-level Medicaid coding rules and guideline review. With thousands of coding edits you can ensure proper application of modifier use, CCI, LCD/NCD, age, gender, add-on codes, code first, code additional, and more. Every edit is sourced back to the proper coding organization that owns the codes and rules (e.g., AMA, CMS, etc.). Optum360 frequently updates edits to ensure you are getting the most relevant edit information.

The EncoderPro.com Expert compliance editor tool allows you to upload the 837 claim file prior to submission to your clearing house and in a few seconds you can see all the suggested claim edits for you to make before submission, which helps improve first pass payment.




NOTE: This item is an add-on to our suite of online products. This item may only be purchased online if you are also buying a new subscription to an online application. 

The Claims Batch Editor Add-on may be added to these online coding tools:

If you are already an active subscriber to one of our online coding applications and you are interested in purchasing an add-on, please contact a customer service representative at 1-800-464-3649, option 1.
  • Leverages Optum360 Claims Manager to do line-by-line claim scrubbing for an entire 837 batch of claims
  • You can scrub a claim based on Medicare, Medicaid, or commercial payer guidelines.   This provides access to thousands of potential coding edits to capture coding issues prior to submission
  • Eliminate the need to enter one claim at a time into EncoderPro.com Expert/Payer compliance editor.  A single click allows you to attach a standard claim file (837 ansi), and review the file for coding issues.   Then you receive a report that reviews, claim-by-claim, line-by-line, any coding issue that can potentially cause a problem 
  • A tremendous ROI opportunity as this helps reduce claim denials and resubmissions.