Overview
What tools are available for scrubbing claims in the EHR?
Elation’s AI Billing solution also provides claim-scrubber-style feedback on the bill before submission, including support for the following areas:- insurance eligibility issues
- Quality reporting requirements
- NCCI rules
- missing drug codes
- Clearinghouse validations
- custom payer-specific rules
Why are the benefits of scrubbing claims?
Scrubbing claims identifies potential rejection or denial issues upfront so you don’t spend time fixing claims later.What will the claim scrubber look for automatically?
Setup
Enabling the claim scrubber
The claim scrubber must be enabled by an Admin Level User by following these steps:Creating custom rules for claim scrubbing
To create custom rules for claim scrubbing:.Sample Custom Rule
Cigna will administratively deny claims when ICD-10-CM Z diagnosis codes Z02.0-Z02.6, Z02.71, Z02.79, Z02.82-Z02.83, Z02.89-Z02.9, Z13.9, Z56.1, Z62.21, or Z63.6 are the only codes on the claim. Knowing this, you can create a custom rule to flag any claim that matches these conditions before it gets denied. To do so:Workflow Instructions
Scrubbing a claim
You don’t need to resolve all errors before signing the visit note or bill — you can sign and come back to make corrections later, as long as the bill remains in the EHR. Any errors associated with a bill can be viewed from the Billing Home .