Claim Scrubbing helps you manage the complex rules and terminology of coding. This feature is used to analyze the claims before submission to the clearinghouse as a solution for catching problem claims, maximizing the potential for your healthcare facility to be paid correctly on the first submission.
Types of Claim Scrubbing Edits
- NCCI Edits: Prevents improper payments of procedures that should not be billed together.
- CPT/HCPCS Edits: Code Validation, Age Validation, Gender Validation, Add-On Code Edit, Relative Value Units sequencing.
- ICD Code Validation: Date of Service, Specificity, Valid Primary Diagnosis, Duplicate Diagnosis.
- Modifier Use: Date of Service, Global Fee Period, Invalid Modifier Use.
- Medical Necessity: Proprietary Medical Necessity, Non-Primary Diagnosis should be primary.
If you're the Auth Rep, follow the steps below to enable, configure, or disable claim scrubbing:
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Select Account Administration > Services.
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Click the button next to Claim Scrubbing.
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The Enable Claim Scrubbing box allows you to enable or disable this service.
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Set your Claim Scrubbing Settings:
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Use the Specialty drop-down menu to select your specialty in order to get tailored edits for your specific claims.
Your initial specialty will auto-populate based on what was set in the Practice or Provider section. If you already have claim scrubbing enabled, you can click "Change" to modify your specialty. 
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Automatically scrub new claims as they are entered?: Select Yes to have the system automatically scrub all new claims after they are entered.
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Automatically scrub existing claims when changes are made?: Select Yes to have the system automatically scrub claims after a coding change has been applied.
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Only perform automatic claim scrubbing for claims that contain more than one charge?: Select Yes to have the system automatically scrub claims only if they contain two lines or more.
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Exclude procedure codes marked as Retail or Other Medical from the code scrubbing process?: Select Yes so procedure codes with the specified types are not included in the Claim Scrubbing process, resulting in misleading errors.
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Optional: Select Copy Configuration to copy these settings to another customer account you manage.
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Check the box next to the customer account(s) to copy the settings to, then click Copy.
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Click Save.
Your initial specialty will auto-populate based on what was set in the Practice or Provider section. If you already have claim scrubbing enabled, you can click "Change" to modify your specialty. 