Healthcare professionals spend years mastering their medical skills to improve patient lives, but rarely does that training include a deep dive into billing, claims, or collections. Yet these administrative tasks can have a huge impact on a practice’s financial health.
When claims are filled out incorrectly or contain missing or inaccurate information, they’re often denied by insurance companies. This kicks off a time-consuming and costly back-and-forth. One study found that reworking a denied claim can cost an average of $118—making inefficient claims processing a serious threat to your bottom line.
That’s where the claims scrubbing process comes in. If you’ve ever wondered, “what does scrubbing in mean” outside the operating room, in this context, “scrubbing medical” claims refers to the process of thoroughly reviewing and cleaning claims before submission. Claims scrubbing tools catch errors in coding, patient details, and payer requirements, helping ensure cleaner claims and fewer denials.
To reduce administrative burden and improve revenue, many healthcare providers are now investing in automated claims scrubbing solutions. Keep reading to learn how the process works, why it’s essential, and the key terminology every provider should 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.
How CollaborateMD Helps Streamline the Claims Scrubbing Process
CollaborateMD’s medical billing software is built to simplify and strengthen your revenue cycle, starting with accurate claims submission. Our platform includes built-in claims scrubbing tools that automatically review claims for common errors, missing data, and payer-specific requirements before they’re sent out. This proactive approach helps reduce denials, accelerate reimbursements, and eliminate the costly delays caused by manual rework.
Whether you’re a small practice or a large healthcare organization, CollaborateMD gives you the tools to:
- Catch errors early in the claims scrubbing process
- Automatically flag incorrect CPT, ICD-10, or HCPCS codes
- Ensure compliance with payer rules and billing regulations
- Reduce administrative burden on front-office and billing teams
- Improve first-pass acceptance rates for cleaner claims
With CollaborateMD, medical billing becomes more efficient and more reliable—freeing your staff to focus less on paperwork and more on patient care.
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
Frequently Asked Questions About Claims Scrubbing
What is the claims scrubbing process?
Claims scrubbing is the process of reviewing medical claims for errors or inconsistencies before they are submitted to payers. It helps ensure accurate coding, correct patient information, and proper billing to reduce claim denials and speed up reimbursements.
What does a claim scrubber do?
A claim scrubber is a software tool that automatically reviews and cleans medical claims by checking for coding errors, missing information, and payer-specific requirements. It helps improve the accuracy and compliance of claims before submission.
Why is claims scrubbing important in medical billing?
Claims scrubbing is essential for reducing denials, accelerating payment cycles, and ensuring that healthcare providers get reimbursed for the care they deliver. By identifying issues early, it prevents costly delays and administrative rework.
What are common errors found during the claims scrubbing process?
Common errors include incorrect or outdated CPT or ICD-10 codes, missing patient details, mismatched provider credentials, and billing for non-covered services. Scrubbers flag these issues before submission.
Is claims scrubbing software necessary for small practices?
Yes, even small practices benefit from using claims scrubbing tools. They help improve billing accuracy, reduce administrative workload, and support consistent cash flow by decreasing claim rejections.
How does claims scrubbing reduce denial rates?
By identifying and correcting potential errors before submission, claims scrubbing minimizes the chances of a payer rejecting the claim. Fewer rejections mean faster reimbursements and improved revenue cycle performance.
