Claims “Scrubbers” Increase Reimbursement of Medical Claims

Wouldn't you like to avoid denials?

Let's look at Claim Scrubbers and how they function to optimize reimbursement of medical claims.

The best medical billing software will have a built in scrubber that analyzes the procedure codes on the claim for any conflicts to the NCCI edits.

If the scrubber finds no conflicts, then you can proceed with submitting your claim without any changes or corrections. If the scrubber does show conflicts between two or more codes, then you now have the opportunity to review and adjust your claim before it is denied.

The billing software should indicate why there is a conflict and maybe all that is needed is a modifier. For example, if it states one procedure is a component of the "larger" procedure, you know to not submit the component procedure.

When you submit a claim that is denied based solely on lack of a proper modifier, you then have to resumbit a "corrected claim". Even thought they are indicated as a "corrected claim", you can now enter the duplicate claim denial loop. You may end up waiting months for reimbursement and wasting countless hours working with the payer to get the claim paid. By taking a few minutes to "pre-check" the claim, all this would be avoided.

Investing in a medical billing system with an integrated claims scrubber you will see greater and faster returns in the reimbursement of medical claims.

Revenue Cycle Management: Accomplished.

START BILLING BETTER WITH SHAVARA

Revenue Cycle Management: Accomplished.

START BILLING BETTER WITH SHAVARA

by Shavara

Shavara has the accumulated 'experience capital', the market know-how, the intricacies of coding, billing and connectivity that we have 'learned'. It is the basis of the work we do in Catalysis - Shavara's Professional Services Engagements.

ThinkCatalysis
Revenue Cycle Management: solved.

What is Catalysis?

To "catalyze" is to rapidly advance by applying powerful tools and industry expertise. Catalysis becomes the process to gain access to the power, apply it to solve gaps and vulnerabilities - then rapidly advance. Shavara possesses the tools to apply Catalysis via collaborative engagements. Our infinite targets are the enterprise organizations: Hospitals, clearinghouse processors, Insurance companies (payers), and large physician practices, peppered throughout the Healthcare system that all share equally the challenges, pitfalls, inefficiencies, ineffectiveness, and the deliberate speed-bumps placed there by bureaucrats to slow down the revenue cycle.

What are the costs of these speed-bumps to the Healthcare system? The costs are in the billions.

Inefficiencies / ineffectiveness / inaccuracies in coding and billing mean:

a higher cost of money due to extended A/Rs
a higher cost of operating due to the number of additional staff required to research and chase down A/Rs
a decline in the quality and calibre of care - care outcomes due to the necessity of placing so much cost on the administrative and operational side of the equation

Therefore, solving this eliminates and holds the potential to improve organizational effectiveness, reduce the cost of healthcare and improve healthcare outcomes.

So, who is Shavara? What is that old lamp on the corner of the desk?

That lamp holds wisdom. The cumulative potential of that wisdom holds the potential to dramatically impact operational effectiveness and improve healthcare outcomes.

For Information on Catalysis contact Shavara's Services Division