Claim Scrubber Wipe out Dirty Claims

Claim Scrubber Wipe out Dirty Claims

Claim Scrubber Wipe out Dirty Claims

In order to achieve faster submission and payment, medical centers should ensure that the claims which are submitted to the insurance companies are clean and free of error. Implementing the process which ensures clean submission of medical claims can reduce the TAT of a billing cycle to less than 45 days. If the claims are submitted cleanly then more than 90% of them should clear in its first submission. This will make the life of medical billing executives much easier and they won't have many issues to pursue. By eradicating the avoidable errors the collection of medical bills increase at a faster pace and the key tool to perform this cleaning job is a claim scrubber which is extensively used in almost all major medical billing service offices. The scrubber compares the claims with the set rules which are used by the claim payers in determining the viability of the claim to be paid.

The basic types of Claim Scrubber used worldwide are basic demographic scrubber and coding and diagnosis scrubber. The basic demographic scrubber makes sure that the basic elements like 9 digit social security number, valid date of birth etc are properly placed in the space provided on the claim forms. The coding & diagnosis scrubber looks for the mismatches in ICD-9 or CPT which are based on Medicare & CCI rules. These rules help in identifying the source of denials as well as the overlooked CPTs.

Billing processes which use Claim Scrubber show a marked improvement over the billing processes which do not use them. However, these scrubbers are not complete scrubbing solutions. The full solution needs scrubbers which can have the customized rule sets taking the knowledge of billing companies and the medical centers and then gets them codified so that they can be applied for all future claims before they are submitted. Knowledge management scrubbers can be considered as the scrubbers which provide the full scrubbing solutions as they allow medical billing operation in continuously re evaluate the rules of each bill payer and update its rules accordingly.

Well designed billing processes in medical and healthcare industry do not allow the errors to proliferate. The system design of this type of medical bill process requires less effort in collecting payments and at a faster pace. Claim scrubber comes handy in this process.

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