Claim Scrubbing When Converting a Superbill to a Claim

About

Scrubbing can occur automatically or manually depending on the global preferences when a superbill is being converted to a claim. See the Claim Scrubber Setup article to enable or disable automatic scrubbing.

  • Automatic scrubbing will occur when clicking the Save or Save + Queue button rom the Add/Edit Charges screen on non daysheeted claims, depending on the user's workflow. Alternatively, the scrubbing process is also triggered on daysheeted claims by clicking on the green Save checkmark on the Edit Archived Claim Transactions Screen. 
  • Manual scrubbing will occur by clicking the Scrub Claim button found at the bottom of the Add/Edit Charges screen. 

In the sections below, you'll learn how the Claims scrubber works when converting a superbill to a claim, depending on your practice's workflow.

Scrubbing Automatically from the Save Button

The Claim Scrubbing settings must be enabled in global settings in order to scrub the claims automatically. The Claim Scrubber will come into effect after you post electronic superbill charges, and this section will go over what happens when you click the Save button.

Once you click the Save button in the Add/Edit Charges window, the claim will be scrubbed automatically, and one of the following options will occur:

Clean Claim 

The scrubbing service does not return any errors.

  • The claim gets a Q0 Category.
  • An entry of SP Scrub Passes will display in the Claim Status History.
  • The claim can be worked as normal from the Claims A/R tab.

Dirty Claim

The scrubbing service returned errors. The following pop-up will appear, stating "The Claim scrubbing has returned errors. Do you wish to view them now?":

  • Click Yes to view the errors.
    1. The Scrub Report tab in the Add/Edit Charges screen opens, with a view of the scrubbing results.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History. 
    3. Edits can be made to the claim from within the Add/Edit Charges window. 
    4. When finished, click Save again to rescrub the updated claim. If the claim is now clean, then the scrubbing service will not return any errors and the next claim in the workflow can be posted.
  • Click No if you do not want to view the errors now.
    1. The Add/Edit Charges window will close.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History.
    3. The claim can be edited and rescrubbed from the Claims in Review tab of the Billing Center.

Scrubbing Automatically from the Save + Queue Button

The Claim Scrubbing settings must be enabled in global settings in order to scrub the claims automatically. The Claim Scrubber will come into effect after you post electronic superbill charges, and this section will go over what happens when you click the Save + Queue button.

Once you click the Save + Queue button in the Add/Edit Charges window, the claim will be scrubbed automatically, and one of the following options will occur:

Clean Claim 

The scrubbing service does not return any errors.

  • The claim gets a Q1 Category and is queued for transmission.
  • An entry of SP Scrub Passes will display in the Claim Status History.
  • The claim can be worked as normal from the Claims A/R tab.

Dirty Claim

The scrubbing service returned errors. The following pop-up will appear, stating "The Claim scrubbing has returned errors. Do you wish to view them now?":

  • Click Yes to view the errors and make changes.
    1. The Scrub Report tab in the Add/Edit Charges screen opens, with a view of the scrubbing results.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History. 
    3. Edits can be made to the claim from within the Add/Edit Charges window. 
    4. When finished, click Save + Queue again to rescrub the updated claim. If the claim is now clean, then the scrubbing service will not return any errors, the claim will be submitted to the Transmittal queue, and the next claim in the workflow can be posted.
  • Click No if you do not want to view the errors now.
    1. The Add/Edit Charges window will close.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category and is not queued for transmission.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History.
    3. The claim can be edited and rescrubbed from the Claims in Review tab of the Billing Center.

Note: If a claim returns errors and you have clicked Save + Queue, the claim will NOT be queued. You will have to review the errors and, if you have the security permission, queue the claim from the Claims in Review tab. 

Scrubbing Manually

You can choose to manually scrub a claim using the Scrub Claim button found at the bottom of the Add/Edit Charges screen. Manually scrubbing the claim will either produce a clean or dirty claim just as it would if the user was automatically scrubbing.

 Once you click the Scrub Claim button, the claim will be scrubbed, and one of the following options will occur:

Clean Claim 

A pop-up will open letting you know that no errors were returned. 

  • You will be returned to the Add/Edit Charges screen where you can either Save the claim or Save + Queue the claim, depending on your practices workflow.
  • An entry of SP Scrub Passes will display in the Claims Status History.

Dirty Claim

The scrubbing service returned errors. The following pop-up will appear, stating "The Claim scrubbing has returned errors. Do you wish to view them now?":

  • Click Yes to view the errors.
    1. The Scrub Report tab in the Add/Edit Charges screen opens, with a view of the scrubbing results.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History. 
    3. Edits can be made to the claim from within the Add/Edit Charges window. 
    4. When finished, click Scrub Claim again to rescrub the updated claim. If the claim is now clean, a pop-up window will appear stating ththat no errors were returned. You will be returned to the Add/Edit Charges screen where you can either Save the claim or Save + Queue the claim, depending on your practices workflow.
  • Click No if you do not want to view the errors now.
    1. The Add/Edit Charges window will close.
    2. The following will be applied to the claim:
      • The claim gets a Q0 category.
      • An entry of SNR Scrub Needs Review will display in the Claim Status History.
    3. The claim can be edited and rescrubbed from the Claims in Review tab of the Billing Center.