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p.36

Charge Capture Strategies for Claim Edits

 Compliance (medical necessity) edits – “front-end” edits

Compile “write-offs” by line item service, department, physician, and  

 registrar

Publish results and communicate to all parties

Use results for educational sessions for registrars/departments

 Pre-bill edits – “back-end” edits prior to claim transmission

Require review by “eagle-eyed” manager prior to reversing to the

 department whose revenue cannot be collected

Post to spreadsheet for reporting to departmental managers

 FISS edits – “return-to-provider” claims with error reason

   codes

Require weekly report (itemized list) by biller or collector of claims in

 the FISS that have not been cleared for payment.

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