We have seen many changes in medical billing for the past few decades. Many healthcare providers have to follow the rules, regulations, and guidelines required by various insurance companies while submitting claims.
Also, they have to make sure if their claims comply with HIPAA or not?. All these requirements are essential to get reimbursements on time.
But many healthcare practitioners and organizations face denials and late reimbursements due to errors in the medical billing and coding. Errors in billing and coding lead to losses of approximately $128 Billion in the US every year.
Claim scrubbing is the process that helps to lower the risk of errors in claim submissions. It allows you to look for any billing and coding errors, and correct them. It can be done manually or automated.
Stick with us to find out what the claim scrubbing process is and how it can help you with accurate claim submission to avoid errors.
What is Claim Scrubbing?
Claim scrubbing is a process that is performed before the submission of claims to healthcare insurance companies. A medical claim has information about the patient, healthcare provider, individual physician, medical staff, and insurer details. It also includes data about the diagnoses, tests, treatments, and procedures performed for a patient.
You have to double-check all the information entered in the claims before submitting the claim. Otherwise, you will experience denied claims and late payments that can affect your revenue cycle.
Claim Scrubbing Can Improve Your Medical Practice
Errors in medical billing are common because the thousands of coding requirements by third-party healthcare insurance create room for coding errors. A single mistake in a submitted claim can lead to denial, and you would not get payments for your medical practice on time.
Your claim has to be 100% error-free for accurate submission of claims. And, even if you submit 100% clean claims, you still might face denied claims. Claim scrubbing helps you avoid further errors for the accurate submission of claims.
The revenue cycle of a medical practice depends on the accurate submission of claims, and clean claim scrubbing can help you achieve more profitability.
It requires thorough research of claims and allows you to make your claims in compliance with all the rules and requirements. Your medical practice can be at risk if you face many denied claims and late or low reimbursements. Hence, you must implement claim scrubbing in your medical billing process.
How Can You Optimize the Claim Scrubbing?
As discussed earlier, claim scrubbing can be manual or automated; it depends on how you want to do it and your budget. If done correctly, it can improve the revenue cycle of your medical practice. The following methods can help you optimize your claim scrubbing process:
Use Claim Editing Software
It is best to use claim editing tools to check if there are any errors in medical codes. Verify if you are using the right codes issued by coding regulatory authorities. ICD-10 includes almost 70,000+ procedure codes and 69,000+ diagnosis codes. And, there are numerous HCPCS and CPT codes as well.
Human errors are the prominent cause of claim denials, so it is sensible to use claim editing tools to avoid claim issues. Automating the claim scrubbing can save you a lot of time and money.
Rectify the Repeated Errors
Sometimes, you might face the same coding errors over and over again. In that case, you need to look for repeated code errors. You can discuss the issues related to coding with the medical staff, administration, physicians, or coders to identify the root causes and rectify them to avoid errors in the future.
Perform a Charge Review
The charge review process is performed before the creation of a claim. It is for finding out any inaccuracies in charges when you are going to bill a patient. Sometimes a claim may be rejected due to errors in the payments charged by a healthcare provider, leading to coding errors.
Various charge review tools can help you automate the process of charge review. The software will check for the mistakes in charged amounts before submitting them in a claim.
Outsourcing Your Claim Submissions
You still might be facing denied claims even after following proper practices of claim scrubbing. It means your office might lack the experience or not be aware of the successful claim practices for dealing with the claims.
Also, If you feel you do not have enough time and budget to manage claims by yourself, you can get a claim handling service from a medical billing company like Med-Miles LLC.
We provide the best medical billing services nationwide and can handle all your claims. We can help you avoid denied claims and late reimbursements with our customized claim processing services.
This way, you won’t have to worry about claim scrubbing by yourself as we will take care of the whole process for you.
When you outsource your claim handling, you can save time for your practice and care for patients. Rely on Med-Miles LLC for all your medical billing needs. Contact us today to get error-free claims and save your time and money for your practice.