Claims Scrubbing and Submission

Claim scrubbing is a proactive process that ensures a claim is meticulously reviewed and cleaned for accuracy and compliance for completion. Once the claim is completed and verified, it is submitted to the insurance payer for payment. This is either done directly by medical billers in the healthcare facility or through a clearing house. Claims can be submitted manually or electronically.

Claims submission

Checking

Scrubbing from clearance house

Each claim is important to us!

We opt for electronic claims submission, which is more straightforward, efficient, and cost-effective. It helps in reducing the effort and cost associated with the paperwork involved in manual claims processing and submission.

We understand the risk of not submitting a scrubbed claim and make sure we check and verify all details to prevent the claim from being rejected by the insurance company for a number of reasons, including improper coding, inaccurate patient demographic, incomplete documentation, and more.

Our team is well-versed with the use of CPT codes. They understand what CPT codes look like, how they are formatted, and when to use which category of codes.

Our turnaround times for claims submissions are short and there are no concerns about claims being lost in transit. The billing expert keeps a close track on the clearinghouse, thereby reducing any delays in the process.

We follow the standard formats currently in place and have checks and balances to protect the privacy of information and ensure the process is in compliance with HIPAA requirements.

Process

Manual claim submission involves sending a paper claim form to the health insurer of other third – party payer through the mail and requires postage. The form contains all registration, charges and provider information.

Electronic claims submission involves submitting a paperless patient claim form generated by computer software that is transmitted electronically over telephone or computer connection for processing and payment.

The processing of the claim by the insurance company is actioned after validating and authenticating the information provided. After this, the company reimburses part or full amount to the healthcare provider or rejects it, basis their evaluation of the information provided. The claim may also be rejected if it is not in the purview of policy terms specified by the insurance company.

Get in Touch

Let’s talk. We will get in touch within 1 business day. No obligation and we don’t share your data with anyone