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Key Issues / Health Coverage and the Uninsured / From Theory to Practice: The Impacts of Uniform and Transparent Claims Edits and Payment Rules

From Theory to Practice: The Impacts of Uniform and Transparent Claims Edits and Payment Rules

January 22, 2015

The Colorado General Assembly in 2010 passed legislation to create the Colorado Medical Clean Claims Task Force. Over the past four years, the Task Force, which is comprised of 25 experts representing national and local health plans, software vendors and providers, has voluntarily developed a uniform set of claims edits to be adopted by commercial payers whohave contracts with providers in Colorado. The Task Force has received national attention for its collaborative efforts. Members of the Task Force were invited to provide testimony on Section 10109 to the National Committee on Vital and Health Statistics (NCVHS).

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