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September 12, 2019

A Clear Path to Clean Claims – CGS Advance Communication Engine (ACE) Smart Edits

In an effort to assist our Part B providers, CGS has implemented an exciting new system known as the Advance Communication Engine (ACE) smart edits. This system is a proactive strategy to assist providers in submitting claims correctly the first time. As CGS deploys an edit, ACE will return pre-adjudicated messaging on your 277CA claim rejection reports.

ACE is available to all electronic claim submitters at no cost and there are no downloads or software required. You receive ACE smart edit messages along with the Health Insurance Portability and Accountability Act (HIPAA) edits you already receive. Please communicate with your clearinghouse to ensure you are able to receive a full 277CA report to include ACE edits.

Currently, you will receive an ACE informational message on your 277CA when a Health Insurance Claim Number (HICN) or invalid Medicare Beneficiary Identifier (MBI) is present on a claim. Soon, we will be deploying and sharing several additional edits. Please watch the CGS email notifications for announcements on these ACE smart edit deployments. If you do not receive our email notifications you can sign-up here!


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