16 Mar Medical Billing Claims– Scrubbers Make for Clean Claims
Chances are if you’re handling your medical coding and billing in-house that you don’t have a claims scrubber assisting you. A claims scrubber is, in essence, a copy editor of medical claims. They review the data contained in each claim before it is submitted to a payer. They are looking for anything that might lead to a claim being rejected, including use of the wrong ICD-10 code, invalid patient identification code, wrong birthdate of patient, and misidentified insurance provider.
The fact is one error will result in a claim being rejected, and too often those claims are never paid because the healthcare provider’s billing personnel are swamped with work and appeals take time. The inability to follow through on an appeal in a timely manner can result in that bill never being paid.
Reducing Claim Rejections
The fact is a good scrubber can catch a huge number of errors, helping to ensure that 90% or more of your claims are honored the first time that they are submitted. That really is the key- making sure that a claim goes out right the first time, which means there will be no need to correct the errors that resulted in a rejected.
Does Your Company Have a Scrubber?
If you decide to outsource your medical coding and billing, first find out if the company has a scrubber who reviews every claim before it’s sent out. Such a company may end up costing a bit more, but that cost can help to reduce greatly the number of first-time rejections. Because of this, the scrubber pays for him/herself.
Coding and Billing Processing
Getting the coding and billing right the first time starts with each healthcare worker’s notes and documentation. Thus, make sure that everything you send to your medical coding and billing office or company is accurate. Rushing to fill out and complete SOAP notes and quickly selecting medical codes may save some office time, but it can be costly to your practice. Correcting mistakes will take more time than if you had gotten the information right the first time.
A professional in the medical coding and billing area conducts the final scrub. They must perform due diligence and be exacting as they check every detail of every claim. Their job is to read carefully and to be able to recognize even the smallest mistake, such as an incorrect date of service, insurance numbers that are one digit off, and other details. After the scrub is done, the claim is submitted.
Get It Correct
Making sure that everyone of your claims undergoes a thorough scrubbing will allow you to verify that each claim is correct. If that is the case, that means that those claims that are rejected are the ones that have real issues related to medical coverage.
It is true that many medical coding and claim software programs contain some form of computerized scrubber. These vary in terms of complexity and completeness. If your coding and claims professionals do use such a scrubber, it’s still important that a trained and knowledgeable professional scrub each claim, giving it one last review and edit before sending it on its way.
MPMR is a top medical billing firm working with practices nationwide. The billing service uses claim scrubbing software to obtain the highest possible first pass claim acceptance. Call us today!