May 2006 Newsletter
The EDGE
Responding to an ever-increasing level of interest in the process and methods by which Quadax determines the why’s and how’s of coding an edit, Quadax has formed the Edits and Documentation Group within the EDI Services Department. The four individuals (Manager Tom Klemens and Analysts Joni Dragin, Barb Ballas, and Linda Davis) that make up the group have been functioning in separate, yet complementary, roles within Quadax, but are now being channeled into what is seen as a new and vital component of the company.
Not a compliance department, per se, this group is responsible for gathering facts and incorporating documentation from implementation guides, payers, and other third-party organizations that can be posted into the Quadax Knowledge Base so that anyone utilizing the Xpeditor application can "right click" on the error message and link to a page that details the rationale and supporting material to justify the edit rule.
The Edits and Documentation Group is already functioning in conjunction with our two Payer Monitoring Committees (the "HCFA" Insurance Committee and the UB Edits Group)— the results of which are chronicled in our monthly newsletter, Connections.
Additional tasks for which the Group is responsible include: maintaining the dynamic payer list; managing LCD and NCD rule changes; monitoring OCE updates; acting as a funnel for all edit requests so that the Blueprint is followed and results can be verified, clarified, and simplified into our edit documentation.
The Group is new, but the personnel and experience derives from an established and valuable set of existing assets. Be sure to watch for announcements related to our improved edit documentation as this group takes on the challenge of this work-in-progress.