A database of claim edits that Stedi publishes to validate claim submissions going through the Stedi Clearinghouse. All edits are returned prior to payer adjudication.
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Claims Edit: A rule or validation check applied to a claim (P - professional, I - institutional, D - dental) to verify the submitted information is complete, accurate, consistent, and compliant with regulatory and billing requirements before adjudication or payment by the payer/health plan.
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→ If you submit a claim that fails the edits using Stedi’s Claim submission APIs or Professional 1500 claim form, you’ll get back an error message in real time.
→ If you submit a claim that fails the edits using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment transaction. The acknowledgment will contain a related Claim status category code, Claim status code, a situation Entity identifier code, and associated Error message. The error messages can be used to correct and resubmit the claim.
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For questions on all things edits, please contact your Stedi account team at [email protected] or use your team’s dedicated slack channel
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We’re always adding to our edits library and would love to hear from you! Click below to request a new edit or enhancement:
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