Come fall, the Pennsylvania Department of Welfare (DPW) will introduce a new system that performs an automated review of Medical Assistance claims before the state pays those claims.
The new system employs a computer program called InvestiClaim that will review claims for procedure or diagnosis codes with inadequate medical documentation, duplicate claims, provider types, license numbers, and other considerations.
The state projects that this new system will save $5 million a year.
The future use of a system to review claims prior to payment was included in Governor Corbett’s original Medical Assistance budget proposal for FY 2013.
Read more about InvestiClaim and how it will work in this PA Independent article.