Scrubbing is the process of identifying issues in your claim which need to be addressed before submission in order to improve your payer acceptance rate. Scrubbing is usually performed by the clearinghouse such as TriZetto. By fixing the identified issues before submission, you will decrease the chance of rejection or denial.
In this article you'll learn:
Why Claims Fail Scrubbing
Some of the reasons why claims may not pass scrubbing include:
- insurance not uploaded
- required insurance fields are missing
- required patient demographics are missing
- required charges information is missing
How to Fix Scrubbing not Passed
1. When you create the claim, an error message may pop up stating Scrubbing is not Passed. You can still click Create Claim Anyway.
A pop up window will direct you to Check Claim Details in order to address the requirements outlined.
Note: You can also click Close, make any needed adjustments to the bill, then try to Create Claim again.
2. In Claim Details, the label indicates Scrubbing not Passed. The system will highlight the number of problems in the claim. Click on Edit, make the necessary adjustments, then Save to fix the problems.
3. To location the problems within the claim, scroll down the page to find indicators in red. In this case, Insurance Type is a required field.
Click on Edit, make the required changes, then click Save.
4. When all problems have been addressed, click Submit Claim.