CORE-842

RECORDKEEPING & CLAIMS

EDIT CHECKS: BEST PRACTICES FOR EVALUATING CLAIM DATA

WHAT IS AN EDIT CHECK?

Sponsoring organizations are required to complete edit checks prior to the submission of their claim. Sponsoring organizations are required to perform edit checks on documentation submitted by facilities to ensure the validity of the claim.

You must verify that each facility has been approved to serve the types of meals claimed.

And, you must compare the number of participants enrolled, multiplied by the number of days that the facility is approved to serve meals, to the number of meals claimed by the facility for that month.

Discrepancies between the facility’s meal claim and its enrollment must be subjected to more thorough review to determine if the claim is accurate.

Let’s explore some best practices when you are completing your edit check:

  • Compare the attendance to meal counts. Meal counts should not exceed attendance.
  • Ensure the facility is not claiming more meals than allowed per participant, by facility type.
  • Ensure the facility is not claiming meals for more days in the month (e.g. thirty days in February) or for days when the facility was closed (e.g. holidays).
  • Conduct milk audits, to ensure that adequate amounts and type of milk are being purchased.
  • Ensure meals meet the meal pattern requirements.

ACTIVITY

Can you think of other edit checks that might be conducted? Enter your answer in the box below. 

CONTINUE