Claims Scrubbing: The Key to a Medical Practice’s Revenue Stream

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A critical part of the medical billing process is the speed at which medical claims are processed. This is where claims scrubbing enters the equation. It can help you save time, money, and stress as it helps the claim get accepted more easily. Meticulous claim scrubbing will determine whether the claim will go through the first time or not. Thus, it is important to understand its role, overall process, and how it affects your medical billing process. 

What is Claims Scrubbing?

Claim scrubbing is a service offered to healthcare providers by third parties. Its main function is to ensure and reduce errors in billing codes, decreasing the amount of denied or rejected claims by medical insurers. It is simply a means for auditing claims before submitting it to insurers. 


The method of auditing can vary per preference. Some claim scrubbers will only verify the required area with given data, while others will expand to check and ensure that all entered data is correct.


Benefits of Claims Scrubbing

A reduction in rejected and denied claims is the main benefit of using claim scrubbing services. The process mostly ensures increased cash flow, since invoices can easily be reimbursed. It further minimizes a healthcare provider’s labor overhead, since less time and money can be spent rectifying incorrect claims.


How it Works

Data from the claims go under thorough review and analysis during claims scrubbing such as:

  • Patient and provider data
  • Age and gender-specific procedures
  • Insurer data
  • Medicare, Medicaid, and other healthcare programs information
  • A procedure/treatment’s medical necessity


You might risk losing patients and revenue if you keep on failing to submit clean claims. Here are common issues on rejected claims:


  • Invalid member ID
  • Missing an admission date for in-patient claim
  • Invalid CPT code for date of service
  • Missing a diagnosis code for the procedure
  • Invalid diagnosis code 
  • Member is not effective on the date of service


Almost any mistake or misinformation on a claim can cause an insurance company to reject it. Even small mistakes like a misspelled name or wrong birthdate will cause the claim to be sent back.

How an Electronic Claims Scrubbing Works

Most medical providers turn to electronic billing services to expedite their claims scrubbing process. Before submitting it to an insurance provider, the claim will be processed through software that reviews for any errors or inaccuracies. Scrubbing saves a tremendous amount of time when done electronically. It can also save your medical staff from tedious and meticulous work. 


In choosing a claims scrubbing software, see if it’s customizable since different practices have a different format. You may want to tailor it to fit your unique program design and existing tools and applications. 


Providing you with the Best

Try using a medical billing service that provides a claim scrubbing feature to lower the risk of denied claims. Optimize your cash flow and relieve your staff from the tediousness of correcting inaccurate claims. At 1st Providers Choice, we understand the needs and expectations of our clients for a higher level of performance and high-quality functioning of medical billing software and service. That’s why we only offer the best billing system with features that will allow your practice to operate at its optimum potential.


You can call us at (480) 782-1116 for immediate assistance, or you can schedule a free demo with our experts TODAY.