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Date To Provider Re Enhanced Claims Controls Update and Reminder In October 2009 AmeriChoice notified you of changes to the manner in which it would implement controls to detect and prevent fraud waste and abuse with regard to the TennCare and Medicare programs utilizing a robust claims editing tool called the Ingenix Claims Editing System or iCES* In late November or early December some of you may have received a notice of recovery from Johnson and Rountree regarding these edits and prior...
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What is re enhanced claims controls?
Re enhanced claims controls refer to an improved system for managing and reviewing insurance claims to prevent fraud and ensure accurate payment.
Who is required to file re enhanced claims controls?
Insurance companies and other entities involved in claims processing are required to file re enhanced claims controls.
How to fill out re enhanced claims controls?
To fill out re enhanced claims controls, follow the guidelines and instructions provided by the regulatory authority or governing body responsible for implementing the controls.
What is the purpose of re enhanced claims controls?
The purpose of re enhanced claims controls is to enhance fraud detection and prevention, ensure accuracy in claims processing, and improve overall efficiency of the claims management process.
What information must be reported on re enhanced claims controls?
The specific information required to be reported on re enhanced claims controls may vary depending on the regulatory requirements, but generally it includes details of the claims review process, fraud detection measures, and strategies for improving claims accuracy.
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