Advanced Code Editing
Taking payment accuracy beyond simple claim editing
While technology-driven primary editors do a good job identifying industry standard edits, a human touch is necessary to find more complex issues. That’s why MultiPlan’s Advanced Code Editing service combines leading-edge technology with expert reviews by our team of physicians, nurses and medical coders to not only identify but also confirm complicated issues. Best of all, we find errors before claims are ever paid so that our clients avoid pay and chase.
Types of Errors Identified
Improper use of modifiers and overrides
Overlapping procedures
Procedures dependent on diagnoses
Provider Mindful
To minimize provider abrasion, our clinical experts verify complex results. To help ensure our edits don’t cause abrasion and are accepted by providers, we have our clinical experts verify results that aren’t black and white. We also make it easy for providers to understand our findings by giving them access to our online portal where they can view explanations of our edits or contact us to discuss them. We’re so confident about our findings that we use Advance Code Editing on claims from the more than 1 million providers in our own networks.
Numbers that Matter
5-6%
Average savings when in the primary position
1-3%
Incremental average savings when not in the primary position
<2%
Corrected charges disputed
24-48 hours
Claims returned
The Ways You Win by Using ACE
Drives savings
Increases payment accuracy
Helps prevent pay and chase
Minimizes provider abrasion
Why MultiPlan Is Different
We're clinically focused
We involve clinicians at every step, including daily claim reviews and provider appeal support.
We go beyond automation
We integrate clinical review to confirm complex issues prior to recommendation.
We know pre-payment
Four decades of pre-pay experience - most claims returned within 24 hours.
We know providers
We contract with over 1.2 million practitioners and facilities; with an appeal rate of 3%, we minimize provider abrasion.
We know waste/abuse
With our long-tenured focus on non-contracted claims, we see the most creative billing schemes.
We're a trusted partner
We are HITRUST certified with nearly 300 payors depending on us for pre-payment integrity services.
Your Payment Accuracy Partner
Better payment accuracy means more affordable healthcare and a stronger provider-plan-patient relationship.
Prevent
Minimize future billing errors with explanations and education that improves the quality of provider billing
Correct
Detect and correct complex billing errors and suspect patterns normally only addressable in a post-payment review
Recover
Focus recovery efforts for more egregious overpayments by lessening the number of incorrect billing scenarios that make it through your pre-payment adjudication
Webpage last updated: 1/9/25