> ## Documentation Index > Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt > Use this file to discover all available pages before exploring further. # AI Billing Guide - Scrubbing claims ## 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? | **Agent** | **Scrubs for…** | | --------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Insurance Eligibility | Verifies patient has insurance information on file. • Verifies active primary insurance coverage at the claim level. • Identifies any potential secondary insurance indicated in the eligibility response. | | NCCI Rules | Flags when the units/quantity for a CPT code on a single Date of Service exceeds CMS limits for that code. • Flags invalid or mutually exclusive CPT code combinations on the same claim and when a modifier is required to bill those CPT Codes together. | | Clearinghouse Rules | Verifies patient has an address on file. • Verifies there are no duplicate service lines. • Verifies there are no \$0 charge lines. • Verifies diagnosis codes exist on all charge lines. • Flags if modifier 95 is associated with the wrong place of service. | ## Setup ### 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)** . | ### Creating custom rules for claim scrubbing To create custom rules for claim scrubbing:. | **1** | Click **Settings** -> **Billing** . | | ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2** | Go to the **AI Billing** section and click **+ Add Validation** . | | **3** | Select the **Claim Scrub Agent** you would like to create a rule for: **Payer** - Create a rule for specific Payers listed. • **Eligibility** - Create a rule based on the patient’s insurance eligibility. • **NCCI validation** - Create a rule based on NCCI rules. • **Clearinghouse validation** - Create a rule based on Clearinghouse rules. | | **4** | Select **Payers** that are tied to this rule, if applicable. You can only select Payers that are in your **Insurance Carriers** list in the EHR. | | **5** | Specify the **Condition** you want the rule to look for. Be as detailed and as specific as you can. | #### 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: | **1** | Go to the **AI Billing** section and click **+ Add Validation** . | | ----- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2** | Select **Payer** under **Claim Scrub Agent** . | | **3** | Select all Cigna **Payers** that are tied to this rule. You can only select Payers that are in your **Insurance Carriers** list in the EHR. | | **4** | Put the following instructions in the **Condition** field: *For patients with Cigna as their insurance, alert me if 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.* | ## Workflow Instructions ### Scrubbing a claim | **1** | Click **+ Add Billing Information** or **Edit Bill** to open the bill. | | ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2** | Trigger the claim scrubber using one of the following workflows: Clicking the **Generate Codes**/**Apply Codes** button that triggers [AI Coding](/articles/AI-Billing-Guide-Coding). • Clicking the **Reanalyze with latest changes** button at the top of the **Billing Analysis** section of the bill. | | **3** | Areas with errors will have a red **Error** label. Review errors by clicking **Show Logs** . | | **4** | Adjust what is needed based on the described errors. | | **5** | Click **Reanalyze with latest changes** button to verify your adjustments passed claim scrubbing. | | **6** | Repeat steps 2- 5 until all errors are corrected. | 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](/articles/Billing-Home) . ## Frequently Asked Questions ### 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](#setup) instructions above to enable the Setting. ### How long does it take for the claim scrubber to detect corrected errors? The claim scrubber will detect corrected errors once you click the **Reanalyze with latest changes** button in the Billing Analysis section of the bill. ## Related Articles * [AI Billing Introduction](/articles/AI-Billing-Introduction) * [AI Billing Guide - Generating billing codes automatically in the EHR](/articles/AI-Billing-Guide-Coding) * [AI Billing Guide - Queueing claims automatically](/articles/AI-Billing-Guide-auto-queue-claims)