Claim scrubbing or Claim submission process involves reviewing the claim data before submitting the claim to payers. We utilize the functionality in the practice management systems to check the data integrity. We identify and correct the rejections and work edits before onward submission to insurance payers.
As many as 10% of healthcare claim face quality, payment, and reconciliation issues. Our work edits and rejection management team will resolve any problems with the claim during submission. The result is that you can address your denials upfront and reduce rework on the claim denials.
Our team offer the following benefits.
Prior-authorization determination and requirements.Submission of authorization paperwork to insurance.Follow-up of the authorization request.Notification and resolution of rejection of authorization application.
Prior to claim being staged to the claim scrubber application, we review the claim using the system functionality.
Automated claim editing to ensure that the claim data is accurate and manual edit is needed.
We review all claim thrown out from the clearing house systems and manually resolve them.
Once the claim reach the payer, the claim are in denied or partially denied conditions and upon receipt of the information, we work with payers to refile claim.
