Claim Editing Policies & Procedures
Overview ClaimCheck® software is a clinically-based procedure code auditing system licensed by CIGNA HealthCare since 1989. Beginning July 21, 2008, CIGNA HealthCare uses ClaimCheck Knowledge Base Version 41, applying the software's rules-based logic to:
- assess provider claims information, including Current Procedural Terminology (CPT®) and Health Care Procedure Coding System (HCPCS) service codes, to detect coding irregularities, conflicts or errors;
- recommend CPT/HCPCS procedure code combinations and, when necessary, request additional claims information; and
- implement the coding guidelines, reimbursement methodologies and coverage policies of CIGNA HealthCare.
Edits
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