Do not let your practice lag due to denied claims and minor errors. Claim scrubbers can bring more revenue into your account and a better success rate.
What is Claim Scrubbing?
Claim scrubbing is reviewing your medical claims for errors that could lead to claim denial by insurance companies. Claim scrubbers do the verification of the Current Procedural Terminology (CPT) codes on your claims, as a single error in the convenient five-digit code can end up in claim denial.
Usually, claim scrubbing is a part of the medical billing services offered by third-party medical billing or software companies. For instance:
- A medical software company detects the possible errors that could lead to claim denial using automated rule engines.
- A medical billing company may employ the scrubbing tool preferred by its clearinghouse partner.
In simpler words, claim scrubbing technology can identify errors quicker than humans and more effectively.
Claim scrubbers give you cleaner claims and a higher first-pass yield – this means increased revenue.
Claim scrubbers act as an intermediate. They review the claims for problems after they are created but before they are submitted to the payers. On detection of any errors, the claim is manually rectified by a medical biller or coder. Claims acceptance is likely if the biller or coder follows the claim scrubber’s specific instructions.
If the biller or coder is mindful of the guidelines and regulations and has a good knowledge of the codes, the claim has a high possibility of being approved and paid.
Types Of Claim Scrubbers
Claim scrubbers are generally divided into two categories: manual and automated. The office team can quickly scrub claims, as they can spot the mistakes in the CPT codes – however, this is not the case. It may be effective if the practice is done on a small scale. But, understanding and scanning hundreds of CPT codes in claims is practically a very tough task – and almost impossible for humans.
Moreover, there is always a possibility of human error. Even if the staff is familiar with the CPT codes, there can be inaccuracy in the entry of codes. Continuously looking at the codes, one after the other, may lead the staff to gloss over the details. This is the stage when you unintentionally miss the apparent typos.
Similarly, at this stage, the team can overlook the coding errors in the claims. Thus, this challenge is best handled by automated claim scrubbers. However, if you wish to proceed with manual claim scrubbing, it is preferred to use medical coding audit to eliminate coding problems and accordingly find solutions.
Benefits Of Claim Scrubbing In Increasing Revenue
Claim scrubbers can transform the outcome of medical practice. Practices are recommended to use claim scrubbing for their medical billing process for the following reasons:
1. Accurate claims
Claim scrubbing offers a significant advantage in generating accurate claims. Frequently accurate claims mean fewer claim denials. The more regularly your claims are correct, the fewer denials you will receive. Consequently, you’ll face fewer challenges while receiving the payments from the payers.
2. Faster payments
The payment process is delayed and dismissed due to denied claims. Receiving approval on the claims guarantees payment. Claim scrubbers can help you get your claims approved. They increase the accuracy of the claim, leading to the payer paying the amount the first time. The practice experiences a better cash flow and boosted revenue.
3. More time to invest in patient care
Doing a manual scan of your claims makes the process error-prone and takes a lot of time. Claim scrubbers allow you and your staff to shift the focus away from this process. An automated claim scrubber handles the work more efficiently and quickly. This leaves the practice and staff more free time for patient care and interactions.
4. Improved payer relationships
For a healthcare organization, it is not the patients who contribute to the revenue but the payers. Repeated submission of claims to the payers can harm the relationship between the practice and the payer. And since every payer has its requirements for submission of claims, it’s likely that they would stop working with the practice.
Claim scrubbers can save your practice and keep it in the good books of the payers. They lead to a substantial reduction in the number of erroneous claims you file, creating better relationships with your payers.
Effective claim-scrubbing methods can also assist you in making a case for yourself when contacting new insurers to widen your network. As a result, the practice would experience a higher patient flow.
5. Healthier patient relationships
Frequently denied claims hurt more than just payers. They upset patients too. When patients expect quality treatment and smooth billing, giving them the news of denied claims does not give a good impression. If this problem continues, it gets difficult for the practice to retain their patients for a long time.
Claim scrubbers can help deal with this issue. They reduce the rate of claim denials, and the practice, as a result, experiences more satisfied patients and a better patient flow. The expectations of the patients are met, and patient retention gives an improved revenue cycle.
Where all billing issues go down to claims, claim scrubbers can assist with fixing the problem at the very source. The revenue is directly linked with claims. Assigning the billing process to a reputed medical billing company that provides automated claim scrubbing can escalate the cash flow and ensure the practice’s success.
- 05 Best Medical Billing Services in 2023
- 6 Key Tips For Building a Thriving Medical Practice
- Why is Hiring a Cost-Effective Medical Billing Company Beneficial For Your Practice?
Author Bio: Natalia Webster is a medical billing expert and a key member of the BillingFreedom team. With years of experience in the healthcare industry, Natalia has a deep understanding of medical billing and coding, and is passionate about helping healthcare providers streamline their revenue cycle management. As a contributor to Fincyte, Natalia Webster shares valuable insights and tips to help healthcare professionals navigate the complex world of medical billing.