Claim Scrubbing

Claim Scrubbing is a process where, prior to billing, your diagnosis and procedure information is transmitted ‘real time’ to a vendor who passes the claim through a series of edits. Any errors are immediately reported in a pop up window on your claims entry screen – allowing staff to correct the claim at that time. Claim Scrubbing can dramatically decrease the percentage of rejected and denied claims.

Things that are checked during the claim scrubbing include:

  • Wrong age for procedure
  • Wrong age for diagnosis
  • Wrong gender for procedure
  • Wrong gender for diagnosis
  • Invalid diagnosis
  • Invalid procedure
  • Invalid modifier
  • Invalid place of service