Don’t let rejected claims or minor errors delay your practice. Billing scrubbers can bring more revenue to your account and increase your success rate.
What is claim scrubbing?
Claim scrubbing is the review of medical claims for errors that can lead to claim denial by insurance companies. The Claims Scrubber performs Claims Current Procedural Term (CPT) code validation, as a single error in a convenient five-digit code can lead to claim rejection.
Bill scrubbing is typically part of a medical billing service provided by a third-party medical billing or software company. for example:
- A medical software company uses an automated rules engine to detect errors that can lead to claim denials.
- Medical billing firms may employ scrubbing tools preferred by clearinghouse partners.
Simply put, claims scrubbing technology can identify errors faster and more effectively than humans.
Claim scrubbers provide cleaner claims and higher first-pass yields. This means more revenue.
A claims scrubber acts as an intermediary. They check for any issues after the claim is created and before it is submitted to the payer. If an error is detected, the claim will be manually corrected by the medical claimant or coder. Claims may be accepted if the biller or coder follows the specific instructions of the claims scrubber.
Claims are more likely to be approved and paid if the claimant or coder heeds the guidelines and regulations and has a good knowledge of the code.
Types of claim scrubbers
Billing scrubbers generally fall into two categories: manual and automatic. The office team can spot the mistakes in the CPT code so they can fix the complaint quickly, but they don’t. It may be effective to do it with a small number of people. However, understanding and scanning her CPT codes in hundreds of claims is actually a very difficult task, almost impossible for a human.
Additionally, there is always the possibility of human error.even if the staff knew CPT code, there may be inaccuracies in entering the code. Constantly looking at code after code can cause staff to lose track of details. This is the stage where you inadvertently miss an obvious typo.
Similarly, at this stage, the team may overlook claims coding errors. Therefore, this challenge is best handled by an automatic claims scrubber. However, if you decide to continue with manual claim scrubbing, we recommend using a medical coding audit to rule out coding issues and find solutions accordingly.
Benefits of claims scrubbing in increasing revenue
Claims scrubbers can change the outcome of medical practices.
1. Accurate claims
Claim scrubbing offers significant advantages in generating accurate claims. More frequent and accurate claims means fewer claim rejections. The more correct your claims are on a regular basis, the fewer rejections you will receive. As a result, you face fewer problems receiving payments from payers.
2. Expedited payment
Due to the denied claim, the payment process was delayed and rejected. Once your claim is approved, your payment is guaranteed. A claims scrubber helps you get approval for your claims. They increase billing accuracy and help payers pay the amount the first time. This practice has improved cash flow and increased revenue.
3. Invest more time in patient care
Scanning claims manually makes the process error prone and time consuming. A billing scrubber allows you and your staff to shift focus from this process. Auto-billing scrubbers process work more efficiently and quickly. This gives clinics and staff more free time for patient care and interaction.
4. Improving payer relationships
For healthcare organizations, payers, not patients, contribute to revenue. Repeated submission of claims to payers can undermine the relationship between practices and payers. Also, every payer has their own requirements for filing claims, which may discourage this practice.
A claims scrubber can save your practice and keep it in the good books of your payers.
An effective claims scrubbing method will also help you make a case for yourself when contacting new insurers to expand your network. As a result, the clinic will experience a higher patient flow.
5. Healthier patient relationships
Frequently denied claims are not limited to payers. They also upset patients. When patients expect quality care and smooth billing, giving them the news that their bill has been denied does not look good. If this problem persists, it will be difficult for clinics to retain patients for the long term.
A billing scrubber can help address this issue. They reduce the rate of denied claims and, as a result, practices experience more satisfied patients and better patient flow. Patient expectations are met and patient retention improves the revenue cycle.
Conclusion
If all billing issues come down to claims, the Claim Scrubber can help solve the problem at the root. Profits are directly linked to complaints. By assigning your billing process to a reputable medical billing firm that offers automated bill scrubbing, you can escalate cash flow and ensure a successful practice.
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Author bio: Natalia Webster is a medical billing expert, freedom of claim 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 revenue cycle management. As a Fincyte contributor, Natalia Webster shares valuable insights and tips to help healthcare professionals navigate the complicated world of medical billing.
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