GAO recommends better use of pre-payment edits

12/12/2012 | Government Health IT online

The Government Accountability Office issued a study showing that the CMS could have achieved greater savings by a wider use of pre-payment edits. The edits compare claims information with Medicare requirements and are controls built into claims processing systems. Although CMS uses three processes to implement edits, the report noted that “each of these processes has at least one weakness.” GAO recommended seven actions to address the situation.

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