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Overview

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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

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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.

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What will the claim scrubber look for automatically?

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Setup

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Enabling the claim scrubber

The claim scrubber must be enabled by an Admin Level User by following these steps:
  1. Click Settings > Billing.
  2. Go to the AI Billing section and set the Billing Analysis toggle to green (ON).

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Creating custom rules for claim scrubbing

Custom rules, also called payer rules, let you tell AI Billing how your practice wants bills handled, including what the claim scrubber should flag. Because a rule can also affect the codes AI Coding generates, rules are covered in their own article — see AI Billing Guide - Creating billing rules.

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Workflow Instructions

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Scrubbing a claim

  1. Click + Add Billing Information or Edit Bill to open the bill.
  2. Click the Generate Codes/Apply Codes button to run AI Coding and scrub the claim.
  3. Review the results in the Billing Analysis section of the bill. Each check appears as a card labeled with its outcome, such as Warning, Failed, or Error.
  4. Expand a card to read the individual checks behind that outcome.
  5. Adjust what is needed based on the described errors.
  6. Run the checks again to confirm your adjustments passed. If the Billing Analysis section includes a chat box, click Generate Codes/Apply Codes again. Otherwise, click Reanalyze with latest changes at the top of the section.
  7. Repeat steps 3-6 until all errors are corrected.
When a rule flags a bill for review instead of changing it, the flag appears under Advisories in the Billing Analysis section, and a marker appears on the service line or diagnosis the flag relates to. Click Acknowledge or Dismiss to record your decision. A flag never changes codes and never prevents you from saving the bill, signing the visit note, or submitting the 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 .

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Frequently Asked Questions

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Why can’t I see the Billing Analysis section in the bill?

You must enable Billing Analysis Settings in order for the Billing Analysis section to appear in the bill. Follow the Setup instructions above to enable the Setting.

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How long does it take for the claim scrubber to detect corrected errors?

The claim scrubber detects corrected errors the next time you run it. If the Billing Analysis section of the bill includes a chat box, click Generate Codes/Apply Codes. Otherwise, click Reanalyze with latest changes at the top of the section.