Benefit Funds to Upgrade Our Claims Auditing Software
This upgrade to ClaimsXten will:
- Improve the accuracy of the Benefit Funds’ reimbursement coding policies;
- Provide enhanced technical functionality, thus reducing the need for manual reviews; and
- Assist with maintaining a consistent payment policy in alignment with CMS and industry standard billing guidelines.
You will continue to be responsible for billing with the most appropriate and valid CPT and/or HCPCS procedure codes, including applicable modifiers, for services that are consistent with the American Medical Association CPT manual and other similar publications. You will see edit reasons and explanations on your remittance notices when claims are not coded in accordance with the appropriate coding guidelines.
For more information, visit the Benefit Funds’ website in the coming weeks, contact your Provider Relations Representative or call our Provider Relations Call Center at (646) 473-7160.