Claims Submission
and Work Edits

Medical claims scrubbing, an important step in the revenue cycle process, requires checking of claims using clearinghouse interfaces prior to submission to the insurance payer. The scrubbing process identifies issues with claims and correct them.

 The benefit of having a work edits team understanding and addressing the issues with claims proactively using claims submission interfaces is that changes can be made instantly, rather than waiting for weeks for a denial to come back from the payer and having to reprocess the claim.

According to the AMA, the expense of inefficient healthcare claims processing, payment, and reconciliation comprises
10-14% of practice revenue.

Atom Healthcare’s claims submission and work edits offer the following benefits:

  • Avoid claim denials and get higher and quicker reimbursement

  • Adhere to practice

  • Reduce costs by 30-40%

  • Reduce claims re-work

  • More efficient revenue cycle operation

  • Coding best practices – avoid unbundling codes, upcoding, incorrect modifier use, inaccurate time-based infusion codes

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