Claim scrubbing enables the potential for increased accuracy in claims, enhanced client relationships, and improved patient interactions.
Claim scrubbing is the process of identifying and rectifying coding errors in medical claims prior to their submission to insurance providers. Whether conducted manually or through automated systems, claim scrubbers validate medical claims before they are sent to payers.
Comprehending the functioning of medical revenue is vital for grasping the concept of claim scrubbing
Providers submit bills, which are then transformed into concise reports by medical coders. Medical billers complete CMS-1500 and UB-04 forms for insurers. Medical billers handle a significant volume of bills each day, ranging from hundreds to thousands, leaving limited time for thorough review of their reports.
In case of Medical claim denials or suspensions due to errors, medical billers must restart the entire process, leading to cash flow issues and increased overhead costs. Scrubbers are typically integrated into third-party medical billing services and are employed by hospitals, dentists, doctor’s offices, and outpatient centers. Auditing medical bills is crucial to ensure accuracy, and scrubbers serve this purpose. While some scrubbers focus on verifying form field completion, others meticulously audit the bills.
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What is the role of a claim scrubber?
There exist two categories of claim scrubbers: those that conduct audits for completeness and those that conduct audits for accuracy. Prior to submission to insurers, both types of claim scrubbers examine reports for errors. They highlight any mistakes for medical coders or billers to rectify. Another term commonly used is “charge scrubber,” which shares similarities with claim scrubbers. However, charge scrubbers differ in their timing of auditing medical billing reports. Unlike claim scrubbers, charge scrubbers identify billing errors before claims are generated, while claim scrubbers identify them after claims have already been created.
The Benefits of Using Claim Scrubbers: Below, we elucidate some of the significant benefits offered by claim scrubbers:
Claims that are precise and error-free: Consequently, insurers receive precise claims during the initial submission, leading to a reduction in claim denials and smoother reimbursement processes.
Enhancements in Client Relationships: Patients who make timely payments are more likely to remain with the medical practice
Improved Time Management for Business Tasks: Due to a streamlined medical billing process, the organization and its staff can allocate more time towards marketing efforts, patient care, and research initiatives.
Enhanced Payer Relationships: In addition to receiving meticulously accurate reports, payers experience reduced overhead costs as they spend less time and effort on rectifying erroneous claims.