New claims edits cause thousands of unnecessary rejections

Article Overview

This article covers an early Medicare Common Working File (CWF) claims-editing issue that affected the matching of physician and hospital claims. It explains why CMS turned off the edits, how the problem affected claim processing, and why the situation matters to practices and billing staff monitoring Medicare payment edits. The discussion is useful for readers following Medicare claims workflow, hospital outpatient billing, physician billing, and carrier/intermediary processing changes.