Healthcare professionals devote what feels like a lifetime to mastering their craft and helping people live more meaningful lives. But in all those years of learning, you probably didn’t take a masterclass in processing claims or getting patients to pay their bills.
Unfortunately, when physicians and their practices lack the experience or expertise in filling out claims correctly, insurance companies often reject those claims. Thus begins a back-and-forth process costing your practice precious time and money. In fact, inefficient claims processing can take a big bite out of your revenue, with one study finding that it costs an average of $118 to rework a denied claim.
To reduce the rate of claims getting rejected or denied, more and more healthcare providers are investing in claims-scrubbing solutions. Keep reading to learn more about claims scrubbing, why it’s important, and some common terms you need to know.
What Is Claims Scrubbing?
Claims scrubbing is the process of checking claims before submitting them to insurers to ensure that they’re accurate, complete, and have the correct codes. This increases the chances the insurer pays each claim quickly.
In the past, claims scrubbing was undertaken manually in what was a long, arduous process, particularly at larger practices. However, in the digital age, more and more physicians are either investing in purpose-built claims-scrubbing technology or partnering with expert billing teams to accelerate the process considerably.
With the right solution in place, practices get the peace of mind that comes with knowing they will get paid sooner by increasing the chances each claim sent to each carrier is accurate every time.
What Are the Benefits of Scrubbing Claims?
Now that you have a better idea as to what claims scrubbing is, let’s take a look at some of the main reasons your practice should invest in tools that improve the process.
1. Faster Payments
Claims scrubbing ensures accuracy and completeness in the claims you submit, leading to quicker approvals and payments. By reducing rejected claims, your practice receives payments faster, streamlining revenue collection.
2. Improve Cash Flow
With expedited payments, your practice benefits from enhanced cash flow. This steady revenue stream makes it easier to manage operating expenses and reinvest in growth areas, such as technology or patient care improvements.
3. Enhanced Patient Satisfaction
Timely and accurate claims processing improves the patient experience. Patients are less likely to face billing errors or delays, fostering trust and loyalty to your practice over the long term.
4. Increased productivity
Claims scrubbing tools save your team valuable time by automating the process and reducing the likelihood of claim denials. This allows staff to focus on delivering exceptional patient care and managing other critical tasks instead of resubmitting claims or addressing rejections.
Investing in claims scrubbing tools not only boosts financial performance but also improves patient trust and operational efficiency, creating a win-win for your practice.
5. Enhanced Compliance
Claims scrubbing helps ensure that claims meet regulatory requirements and adhere to payer guidelines, reducing the risk of non-compliance issues. By minimizing errors and maintaining accurate documentation, your practice can avoid penalties, audits, and delays caused by non-compliant submissions. This added layer of accuracy protects your practice and builds confidence in your billing processes.
Claims Scrubbing: Key Terms You Need to Know
To better understand the claims-scrubbing process, it’s important to familiarize yourself with these commonly used terms:
1. Superbill
A superbill is a detailed document that lists the services provided to a patient, including the date of service. It serves as the foundation for creating a claim, ensuring all necessary information is included.
2. Claim form
A claim form is the document submitted to insurers to request payment for services rendered. It includes information derived from the superbill and outlines why the insurer should pay either the practice or the patient.
3. Claims editing
Claims editing involves reviewing and correcting claims to ensure accuracy before submission. By identifying and fixing errors in advance, this process reduces denials and speeds up payment timelines.
4. Charge review
The charge review process involves comparing a practice’s rates with the standard rates established by insurance providers, Medicare, and Medicaid. This ensures charges are compliant and minimizes discrepancies during claims submission.
5. Coding errors
Coding errors occur when incorrect information is entered on a claim form, often leading to claim denials. These mistakes can delay payments, frustrate patients, and disrupt cash flow.
Understanding these terms can help your practice streamline the claims-scrubbing process, reduce errors, and ensure faster payment cycles, contributing to improved operational efficiency and patient satisfaction.
Save Time and Boost Revenue with CollaborateMD’s Medical Billing Software
Looking to streamline your billing process and maximize efficiency? CollaborateMD’s medical billing software includes powerful claims-scrubbing tools designed to expedite your revenue cycle. By reducing claim denials and ensuring faster payments, we help practices like yours save time, minimize errors, and focus more on delivering quality patient care.
Ready to see the difference CollaborateMD can make for your practice? Use our revenue calculator to discover how our solutions can enhance your cash flow and simplify your billing operation
