Clear Claim ConnectionTM is a web-based tool that allows you to prescreen claim edits.

Disclaimers:

  • No protected health information (PHI) will be displayed
  • Does not contain edits that occur outside of ClaimsXten
  • Services must be entered on the same claim for a single provider
  • Does not guarantee final disposition due to  specific variations within provider and group contracts
  • This tool only provides correct coding information (it does not consider pre-authorization requirements, benefits, or pricing)
  • We do not warrant this tool will meet your requirements, or that your access or use of this tool will be uninterrupted, timely, secure or error-free
  • To use the Clear Claim Connection tool, you must have at least Internet Explorer version 6.0 or higher
  • The code auditing edits included in Clear Claim Connection are used by our health plan
  • Clear Claim Connection cannot be used for FEP claims
  • Clear Claim Connection uses defaults for commercial and Medicare Advantage
  • Clear Claim Connection should only be used for claim scenarios for professional services

How to access Clear Claim Connection

To access the tool, sign into the Availity portal. The tool is located in the main menu: More>Claims>Research Procedure Code Edits.

If you do not have an Availity account, please register today.

Entry screen

 

Claim audit results

Results are based solely on entered data elements.

 

Clinical edit clarifications

This screen includes:

  • Sources
  • Link to print
  • Response text
  • Procedure details

 

 

Training video