Medical Claims Scrubbing Software For Squeaky-Clean Claims
Health professionals, hospitals, and clinics interested in improving revenue flow should consider using medical claims scrubbing software.
Medical Claims Scrubbing Software Improves Revenue Flow
What is the Purpose of Claim Scrubbers?
One of the most important aspects of medical billing is the ability to process claims quickly. Nonetheless, it negatively affects the revenue flow if quick processing results in repeated denials.
However, PrognoCIS’ claims scrubber software can improve revenue flow by quickly, and accurately creating squeaky-clean claims.
With claim scrubber software, instead of spending time investigating and then addressing denials, staff can improve each patient’s overall experience.
What Are the Benefits of Using a Medical Claims Scrubber?
The quickest way to improve revenue flow is by submitting an error-free medical claim.
Claim Scrubbing in Medical Billing Helps Prevent Denials
After a claim denial, the provider must correct and resubmit the claim in a timely manner. A clean claim in medical billing helps prevent insurance denials, consequently, using claim scrubbers improves revenue flow.
Eliminates the Need for Manual Claim Scrubbing
The customizable, practice-specific claim scrubbers that PrognoCIS’ medical billing software provides eliminate the need for manual claim scrubbing. In addition, using well-designed claim scrubber software makes it possible to achieve a first pass ratio of as much as 97 percent.
Overlooked Denials Result in Lost Revenue
With PrognoCIS software if there is a denial, the likelihood of receiving the highest payment possible increases.
Here is why:
Fewer denials usually make it easier for staff to quickly fix and resubmit claims.
Reduce Claim Status Inquiries to Increase Profit
According to the 2019 CAQH INDEX®, just inquiring on the status of a single claim costs $7.22. PrognoCIS’ claim scrubber software allows staff to submit clean medical claims and, as a result, decrease the frequency of inquiries.
PrognoCIS Medical Claim Scrubber: Here's What We Offer
PrognoCIS’ software supports built-in scrubbers to ensure clean claims:
- Date validation for code sets
- Built-in date validation for ICD, HCPCS, and CPT code sets decreases the number of claim denials resulting from outdated and improper coding.
- Automatic Medicare National Correct Coding Initiative (aka NCCI or CCI) edits:
- The automated NCCI procedure-to-procedure (PTP) code pair prevents the hassle of receiving an incorrect payment amount for services covered under Medicare Part B.
- Validation of claim information regarding the patients:
- Age and gender-specific diagnosis codes.
- PrognoCIS’ claim scrubber software also offers:
- Customizable local and national coverage determinations (LCD/NCD) for select specialties and states.
The denial analysis report in PrognoCIS RCM helps identify denial trends that need to transpose into a scrubber check to prevent future denials.
Utilizing claim scrubbing software or outsourcing the services to a revenue cycle management vendor, reduces the turnaround and boosts the revenue flow.