ClaimScrub™

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.

Best-of-Breed Data

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

Medical Necessity 

Utilize coverage requirements for Medicare, Medicaid and dozens of private payers.

Correct Coding

Validate codes, modifiers, CCI, quantities, bundling and more.

Contextual Feedback

Know the problem, how to fix it, complete with a link to the source.

Support

100% originally sourced data curated by our nationally certified content team.

Claim and revenue cycle management are mission critical.

When claims are done right the first time, your organization saves time, money, and resources that can be better allocated toward supporting patient/member care. Save staff time, reduce exposure and protect your bottom line with ClaimScrub.

To get started, call us at (888) 395-9029 or complete the form below for us to get in touch with you.

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Experience the Synergy

When we say the Valenz ecosystem is comprehensive, we mean it. With a complete selection of fully integrated wraparound solutions to complement the core solutions featured below, we deliver benefits far greater than the sum of all these parts individually.

Vālenz Access

Combine a quality-first provider network or open solution with a range of customized, data-driven services from the Access Solutions Suite.

Vālenz Care

Guide members to better care and outcomes at lower costs, for you and for them, with RN-led, triple URAC-accredited care management.

Vālenz Claim

Reduce costs and ensure accurate payments with comprehensive bill reviews and repricing methodologies, integrated analytics, and more.

Vālenz Assurance

Improve coding, reimbursement assurance, auditing, claim accuracy and compliance monitoring, all while saving time and costs.

v-Lens

Use advanced, drill-down analytics and predictive modeling to continuously disrupt the cost curve without compromising quality.

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