NOTICE: This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware.
Charge Capture Strategies for Claim Edits
Compliance (medical necessity) edits – “front-end” edits
Compile “write-offs” by line item service, department, physician, and
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
Require weekly report (itemized list) by biller or collector of claims in
the FISS that have not been cleared for payment.