Claim submission
What service we provide in claims scrubbing or submission?
• Efficient Claims Submission: Utilizing advanced technology and expertise to ensure fast and accurate submission of claims, reducing delays and denials.
• Comprehensive Work Edits: Rigorous editing process to identify and correct errors before submission, improving the accuracy and acceptance rate of claims.
• Real-Time Tracking and Reporting: Keeping you informed with real-time updates on the status of your claims and providing detailed reports for transparency and accountability.
• Customized Solutions: Tailoring our services to fit the unique needs and challenges of your practice or healthcare facility.
As many healthcare claims face quality, payment, and reconciliation issues. Our work edits and rejection management team will resolve any problems with the claims during submission. The result is that you can address your denials upfront and reduce rework on the claim denials.
What we follow:
• Edits on practice management system: Prior to the claim being staged, we check for demographics, date, providers, place of service and services rendered. We review the claims using the system functionality.
• Biller Scrubber edits: We ensure that the claim data is accurate and properly inspected by our rejection management team.
• EDI rejections: Our rejection management team has checked and resolved any problems prior to submission. We review all the claims through clearing house systems and manually resolve.
• Payer rejections: Once the claims reach to the payer, Sometimes their automated system, rejects the claims. Our rejection management team identify the reasons, rework and refile the claims successfully in timely manner.
What is claims scrubbing or submission process?
Claims scrubbing or submission process involves reviewing the claim data before submitting the claims to payers. We identify and correct the rejections and work edits before onward submission to insurance payers.
Claims processing is the tracking, documenting, and paying of claims. After the claim data is entered into the software, it goes through a process called “claims adjudication.” The company checks the validity of the claim by comparing it against the coverage and benefit requirements of the health plan. The insurance claim life cycle has four phases: adjudication, submission, payment, and processing.
