Clear Claim ConnectionTM is a web-based code auditing reference tool designed to mirror how Claim Check® evaluates code combinations during the auditing of professional claims. Clear Claim ConnectionTM enables Independence Blue Cross (IBC) to disclose its claim auditing rules and clinical rationale inherent to the Claim Check® system. Through this tool, you can view the justifications and clinical rationale on why code combination logic was applied to a professional claim processed in the base claims processing system.
The Significant Edits Disclosure Report is a searchable list of ClaimCheck® Significant Edits. A Significant Edit is defined by IBC as any ClaimCheck edit that results in the denial or reduction in payment for a particular CPT Code or HCPCS Level II Code more than 2000 times a year. This report will be updated annually.
Clear Claim Connection User’s Guide
