Tired of submitting claims to insurance and spending what seems like countless hours on follow-up to iron out details and make sure your practice gets paid? Don’t despair – make effective claim scrubbing your spring resolution. This essential tool in practice management software can clean up your claims before submission and give your practice relief from an endless cycle of “review and resubmit” that can eat so much of your staff’s time.
According to Healthcare IT News, “On a typical day, several million medical providers using hundreds of information technology applications submit tens of millions of medical claims to thousands of insurance carriers.” Medical billing
clearinghouses guide that information to its destination, while also correcting errors, to help avoid system crashes.
Software review site CTS Guides notes that medical claim scrubbers should include these important components: 1) checking for valid diagnosis and procedure codes; 2) auditing for valid revenue codes; and 3) validating medical claims against Medicare, Medicaid, and National Correct Coding Initiative (CCI) Edits.
Claim scrubbing software checks each batch of claims against insurance carrier rules to ensure requirements are satisfied before submitting. While not foolproof, this does help decrease denials coming back from the carriers and allows staff to focus on resolving the reduced number of issues that remain. When claims are scrubbed before submitting to insurance, you can also find the highlighted items that the scrubber was not able to fix automatically and take steps to correct them before submitting so that your batch of claims goes out in the best order possible.
When preparing to submit claims to the clearinghouse, Duxware allows users to compile a Transaction Integrity Report, which checks the claim data for irregularities. Once these irregularities are identified, staff can review them to figure out how to remedy them before submitting the batch of claims. This almost acts like a spell-check for your claims, allowing you to fix any discrepancies in each claim before it is fully processed. Claims that are submitted “clean” can then be processed more quickly by the clearinghouse, giving you fewer headaches from rejected claims or requests for additional information. And quicker turnaround means quicker payment for your practice.
So, save some time by making the most of your claim scrubbing software – and enjoy sunny interactions with your patients instead!