Healthcare centers can achieve a significant improvement in the speed and the volume of the medical billing and collection by using claim scrubbers which help in performing quality checks and the re evaluation of the medical bills which are sent to the bill payers for collection.
Claim Scrubber analyzes claim data on the claim form and compares the same to its own rules engine before the claim is submitted for collection. There are many levels of scrubbing and a good scrubber will analyze the data on many levels. The most important scrubbing function is to ensure that all the required data is present on the form in a defined order. For example, scrubber will check to ensure the name of the patient, his/her valid date of birth, information about insurance policy with the id number etc. It will also check the presence of date of service & the procedure with diagnosis code. It might not verify the accuracy of the input data. A basic claim scrubber will not notice any typo error like date of service. To a medical center it is obvious that their entry person has made a typo which the basic scrubber might not catch.
Another error which the basic Claim scrubber may not catch is the invalid insurance ID number. Medicare id numbers are social the security numbers of the patients followed by any letter or any number. If the medical biller enters the claim data and misses a number by mistake, the same may not be noticed by the basic scrubber where as a good claim scrubber will pick the error as it knows that there should be nine digits instead of eight and issue a warning to the billing executive regarding the error.
Claim scrubbers these days have many more capabilities as they not only check the presence of the required data, they also verify the medical codes which are a necessary input in medical billing and most of the bills get rejected due to wrong coding entered while submission. These scrubbers utilize the rules from the major insurers in order to detect the mismatches and the combinations which are not valid. If the data does not meet the guidelines of the insurers, the user will get a warning and needs to correct before proceeding. The web based software has further improved their functionality and capabilities.