Claim Scrubbing
Every claim runs through payer-specific edits and a human review pass before submission, targeting a first-pass acceptance rate above 95%.
- 95%+
- First-pass acceptance target
- Automated + human
- Scrub layers
- 40+ edit rules
- Pre-submission checks
What this actually involves
A denied claim costs roughly $25 to $118 to rework — and a third of reworked claims are never resubmitted at all. Scrubbing is the cheapest point in the cycle to fix an error. We run automated edits for eligibility, NCCI conflicts, modifier logic and demographic mismatches, then add a human review pass for the categories automation reliably misses.
How we run it
- 1
Automated edits
Each claim passes a rules engine covering eligibility, bundling and formatting.
- 2
Human review
Flagged and high-dollar claims get a manual read before release.
- 3
Correction
Failures are corrected at source, not patched at the claim level.
- 4
Pattern analysis
Repeat failure reasons are traced back to coding, entry or front-desk workflow.
Claim Scrubbing, specifically
Related services
All servicesReady to fix claim scrubbing?
Send us a sample of your recent claims and we will show you exactly what is going wrong and what it is costing.
