Code Auditing for Medical Claims
Our code auditing for medical claims uses McKesson Health Solutions LLC ClaimCheck® software, a clinically-based system that evaluates claim information. The extensive knowledge base functions with the software to assist you with automating coding and medical policy decisions as well as to detect coding irregularities, conflicts, or errors. The software also contains customization capabilities that allow each customer to reflect the payor's unique coding guidelines, reimbursement methodologies, and medical policy.
Refer to CDPHP Payment Policy 1550/20.000162; Code Auditing Customization, for custom edits. Specific coverage is always subject to the member's eligibility, contract benefits, and CDPHP medical policy.
(The above is printed with permission of McKesson Health Solutions, LLC.)