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August 28, 2019

Coming Soon: ACE Smart Edits!

CGS is excited to announce we will be implementing our new CGS Advanced Communication Engine System (ACE) smart edits! ACE is available to all direct submitters as well as those who transmit claims via clearinghouses/billing services. Once ACE edits are implemented, new clearinghouse "Smart edits" will appear on claim rejection reports (277CA). ACE returns pre-adjudicated claims information through claim acknowledgement transaction reports sent by your clearinghouse based on the Medicare 277CA. All direct submitters will receive the Medicare 277CA report with the new smart edits. Some edits will be informational, while others may require additional action. Claims failing the pre-adjudication editing process are not forwarded to the claims adjudication system. ACE will work with your current clearinghouse/billing service workflow so you can modify claims before the MCS system receives them. After you have reviewed the ACE edit, if you choose not to change the claims, you can resubmit in its original format and it will pass to the MCS claims adjudication system for processing. ACE is available to you at no cost! No downloads or software is required, as ACE is incorporated in your normal EDI stream. Coming soon! Stay tuned for more details!


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