Why Claim Scrubber is a Must-Have for Better Medical Billing

One of the biggest challenges in revenue cycle management is claim denials. Which ultimately leads to a loss of revenue for healthcare practice. However, most physicians may not have expertise in claim processing and often get denied by insurance companies.

A study found that it costs an average of $118 to rework a denied claim. To reduce the rate of getting denied by insurance companies, healthcare providers are investing more in claim scrubbing solutions. 

If you are wondering what is it, this blog post will guide you. Learn what is claim scrubber and why it is necessary for medical billing.

What is Claim Scrubber?

Claim scrubbing is a process of checking claims beforehand and submitting them to the insurance companies to ensure that the claims are accurate and correct. 

This will ensure increasing the chance of getting paid as quickly as possible and reducing the chance of getting denied. Here is the process of claim scrubbing:

• Checking and verifying data entries
• Following proper coding guidelines
• Finding missing or wrong information
• Avoiding claim rejections or denial
• Making sure claims are accurate for reimbursement

In the past, healthcare providers used to manually work on the claim scrubbing process which is more time-consuming and chances of errors. 

However, with the revolution of the digital era, healthcare providers are investing more in technology solutions for claim scrubbing or relying on external billing teams to get it done.

Related: 8 Actionable Steps to Increase Your Practice Revenue by 10x with RCM

The Importance of Claim Scrubber

After the healthcare providers provide healthcare services to patients, the practitioners have to send clean and perfect claims to the insurance companies to get proper reimbursements for the service provided. 

A clean and faultless claim, as defined by MSMA, is one that “has no errors or defect or impropriety,” including any absence of the necessary supporting documents or a unique situation necessitating special handling that would otherwise prohibit prompt payment. Claim scrubber is important because:

• It helps to reduce claim denials, which means profitability
• Ensures that your medical coding is accurate and follows all the rules.
• Makes the entire medical billing process much smoother and easier.
• It can spot coding mistakes and help you fix them before they become issues.
• Boosts efficiency and saves you money in the long run.

Claim Scrubbing Essentials

The US Healthcare industry is different from others. It typically involves a more complex and multi-set of processes than just delivering care for patients. 

However, most healthcare providers are willing to spend more time on patient care instead of spending on medical claims and other related complexities. 

Inefficiency and a not-perfect claim process can lead to revenue loss for healthcare practice. As a solution, the claim scrubber helps to solve any problems associated with medical billing.

Understanding claims scrubber is necessary even though it is complex. Here are the 3 breaking down into three essentials:

1. Medical Claims

The process of medical billing starts with the healthcare providers providing services to a patient. To receive payments for the service provided, healthcare providers must submit claims to the insurance companies for reimbursement.

However, the insurance companies won’t automatically approve the claim just after submitting it. Most of the people believe that having medical insurance means that their treatment can be fully covered.

Health Insurance Companies often go through all the claims to carefully analyze and often reject or deny them for common information such as:

• Incorrect Information
• CPT Codes
• Service Providers

2. CPT Codes

In the medical billing process, assigning the right accurate CPT codes is needed. Before, the medical billing process involves submitting all the essential information to the insurance companies so that they can assess. This makes the process more complex to work on for claim approvals.

So, the medical billing community introduces medical codes to streamline the process. Instead of explaining each case in detail, medical professionals use codes to denote specific forms of diagnosis and treatment, etc.,

This approach has received widespread acceptance in the medical community, but it is associated with challenges.

The large margin of error associated with Current Procedural Terminology (CPT) codes is its primary drawback. 

One incorrect number is all it takes for an insurance company to reject a claim. In addition, CPT codes are updated frequently to adhere to HIPAA, and the Health Insurance Portability and Accountability Act. 

Keeping track of this can be challenging and time-consuming, which raises the possibility of error. Indeed, proficient claim scrubbing can assist in locating any mistakes before submitting a claim.

3. Service Providers 

Even though healthcare professionals used to spend more time manually checking the claims before submitting them, it may result in claim denials. 

This is why relying on professional claim scrubbing companies can be a better option for healthcare practices. They have software that automatically checks the claims.

By serving as a sort of middleman between insurance providers and medical facilities, these companies help to streamline the entire process and reduce stress for all parties.

They are skilled at identifying warning signs and opening doors for your business. They free up time for healthcare practitioners, enterprises, and practices so they can concentrate on their patients.

Related: The Challenges Associated with Revenue Recovery and How to Solve Them

Benefits of Claim Scrubbers for Medical Billing

1. Getting Fast Reimbursements

One of the benefits of using a claim scrubber for medical billing is that it speeds up payment collection. This process improves the quality, accuracy, and completeness of claim submissions.

Ultimately reduces the claim rejections your practice encounters, and ensures getting faster reimbursements.

2. Improves Cash Flow

By speeding up the payment collection process, healthcare practices can gain profitability. This results in improved cash flow, making it easier to cover operating expenses and invest in other areas of your practice.

3. Reducing the Time Spent

Checking claims is complex which is more time-consuming.

By utilizing a claim scrubber, healthcare providers can save more time associated with manual processes. It will ensure spending less time on reviewing the claims for errors.

4. Payer-Patient Relation

The process of filing a claim can be costly and time-consuming for all parties—provider and patient alike. By saving money on these priceless goods, a successful claim-scrubbing service will guarantee the best possible experience for all.

Vozo Revenue Cycle Management to Increase Your Practice Revenue

At Vozo, we understand your struggle in navigating through all the revenue cycle processes such as regulations, medical coding, and reimbursements. 

That’s why we bring the best cutting-edge service to optimize your revenue cycle management from start to finish. Here’s how Vozo can help you to transform your practice’s financial performance.

• Automated tools for error-free coding and faster reimbursements
• User-friendly billing to keep patients satisfied and payments flowing
• Robust data security and compliance protocols to protect your practice
• Detailed reporting and analytics for smarter business decisions
• Solutions that grow alongside your evolving needs

With Vozo RCM service, you can reduce the headaches associated with revenue cycle management and focus on what matters the most – quality patient healthcare delivery.

“Partner with Vozo RCM Service and unlock the full potential of your healthcare practice and maximize its revenue”.