Take the complexity out of claim management and payment integrity
Whatever space your team occupies in the life cycle of a medical claim, you have good reasons to seek solutions that ensure coding and coverage accuracy. Whether you are a healthcare organization that needs to protect reimbursement revenue by preventing claim denials, or a payer looking to protect payment integrity by preventing overpayments, ClaimScrub™ empowers your team to verify correct coding and coverage with precision.
Compatible with a wide range of health IT systems – including Epic, MediTech, Iatric and many others – and able to be custom integrated with a variety of claim adjudication platforms, ClaimScrub is the complete package. From best-of-breed data to integrated claims review/editing and insightful dashboard reporting, ClaimScrub delivers the clean claims every business needs for enhanced efficiency and revenue health.
With an average of 10,000 changes per week to coding and coverage rules for Medicare, Medicaid and private payers, getting everything right on every claim requires a very strong foundation of reliable, up-to-date data. We curate and validate every change to ensure accuracy for you and eliminate significant time and hassle for your team. Our nationally certified coders and content teams push daily updates via DataTank™, the industry’s most reliable curated data libraries.
Automated Claims Review & Editing
As a fully integrated solution that scrubs all inpatient, outpatient and specialty claims with unparalleled accuracy, ClaimScrub is the industry’s most reliable and comprehensive rule engine. Our process provides full verification of correct coding and coverage, and we work with you to establish custom edits or modified rules, configure specific modules, or integrate the processing power of ClaimScrub into other applications.
The custom edit engine allows your organization to meet its exact needs and extends ClaimScrub’s functionality for the last mile, with full documentation and transparency.
With ClaimScrub, your team gets the error alerts and green lights they need for efficient, accurate claim handling in real time or in batch mode, across pre-service, post-service and audit implementations.
ClaimScrub at a Glance
Utilize coverage requirements for Medicare, Medicaid and dozens of private payers.
Validate codes, modifiers, CCI, quantities, bundling and more.
Know the problem, how to fix it, complete with a link to the source.
100% originally sourced data curated by our nationally certified content team.