Provider Resources

Advanced Communication Engine (ACE) Smart Edits

New Tool for Clean Claims—ACE Smart Edits

WPS is implementing a new free tool to assist our GHA providers. The ACE Smart Edits are a proactive tool that helps submit claims correctly the first time. ACE Smart Edits help improve claim accuracy, decrease denials, and reduce appeals and reopenings. This tool will be available to all who submit claims via 837 electronic claims submissions, whether clearinghouse, billing service, or direct submitter. No new software or downloads required!

ACE will be the first stop of the normal EDI processing. ACE scans the claims prior to entry to the FISS and MCS and identifies issues that may interfere with clean claim processing. All ACE actions are pre-adjudication. As we implement smart edits, information will appear on the ASC X12 277CA Claim Acknowledgement. Some edits are informational only, while others may require additional action. After you have reviewed the 277CA, you can resubmit rejected claims using the information provided on the report.

Also, watch your GHA eNews notifications for announcements on these ACE smart edit deployments. If you do not receive our email notifications, please sign-up here.

More information coming soon!

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