Clean Claims In. Faster Processing. Fewer Preventable Errors.
Accurate claim submission is critical to timely reimbursement. Our Claims Submission and Scrubbing services help healthcare organizations validate claims before transmission and identify common demographic, coding, billing, and payer-related errors.
We support electronic claim workflows using appropriate EDI transactions, including the 837 healthcare claim transaction, helping improve claim quality before submission.
Systematic compiling, formatting, and electronic dispatch of professional (837P) and institutional (837I) healthcare claims to commercial and government payers.
Learn moreComprehensive compliance with ANSI X12 837 standards, ensuring syntax validation, proper loop and segment formatting, and secure clearinghouse transmission.
Learn moreMulti-tiered algorithmic validation checking diagnosis-procedure crosswalks, gender and age consistency, medical necessity, and CCI bundling rules.
Learn moreVerification of patient demographics, subscriber details, policy numbers, and guarantor information to prevent avoidable registration discrepancies.
Learn moreVerification of active coverage, effective dates, primary/secondary coordination of benefits (COB), and payer ID routing before submission.
Learn morePre-submission audit rules verifying appropriate CPT/HCPCS codes, ICD-10 specificity, required billing modifiers, and accurate units of service.
Learn moreCustom rules engine applying distinct commercial, Medicare, Medicaid, and regional payer billing requirements and local coverage determinations (LCDs).
Learn moreAutomated pre-transmission safeguards identifying identical or overlapping service dates, provider IDs, and procedures to prevent duplicate denials.
Learn moreRapid parsing of 277CA clearinghouse rejection notices and payer acknowledgment reports to quickly remediate errors before claims age.
Learn moreFinal automated and expert quality-assurance reviews confirming complete documentation attachments, authorization numbers, and clean claim viability.
Learn morePre-submission validation helps identify preventable errors before claims reach the payer.
Systematic claim scrubbing can reduce common technical and data-related rejections.
Cleaner claims can move more efficiently through payer processing.
Early error identification reduces downstream correction activities.
Connect with our claims submission and scrubbing specialists today to streamline EDI 837 transmission and elevate first-pass acceptance.
