Private Payer: BCBS of Texas Enhancing ClaimsXten Code Auditing Tool


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Topic Private Payer: BCBS of Texas Enhancing ClaimsXten Code Auditing Tool
Background The ClaimsXten tool offers flexible, rules-based claims management with the capability of creating customized rules, as well as the ability to read historical claims data.
Regulating Body BCBS-TX March 2013 Blue Review
Compliance Date 5/6/2013
Consequences Changes to the tool may result in changes in reimbursement for some services.
Next Steps ​Physicians should utilize Clear Claim Connection on the BCBSTX website to help determine how coding combinations on a particular claim may be evaluated during the claim adjudication process. This tool helps physicians determine what payment amount should be collected from the patient at the time of service.
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