Claims Submission

Work Edits and Rejection Management

The process of reviewing claims data before submission to payers, commonly known as claims scrubbing or submission, is a crucial step in ensuring accuracy and efficiency. Utilizing the advanced functionality of practice management systems, we thoroughly check the data integrity to catch any errors or inconsistencies. By identifying and correcting any rejections or edits, we ensure a smooth and successful submission to insurance payers.

Our Work Edits and Rejection Management Process

Did you know that up to 10% of healthcare claims encounter obstacles related to quality, payment, and reconciliation? Our team of dedicated editors and rejection managers are equipped to handle any issues that may arise during the submission process. By addressing potential denials upfront, our services can help reduce the need for additional work on rejected claims, allowing you to focus on other aspects of your practice.

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Edits on the Practice Management System

Prior to claims being staged to claims scrubber application, we review the claims using the system functionality.

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Bill Scrubber Edits

Automated claims editing to ensure that the claim data is accurate and manual edits as needed.

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Clearinghouse Edits

We review all claims throwing out from the clearinghouse systems and manually resolve.

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Payer Rejections

Once the claims reach the payer, the claims are in denied or partially denied status and upon receipt of the information, we work with payers to refile claims.

Benefits offered by our Claims Submission Team

Soho Tech Services claims submission -work edits and rejection management teams offer the following benefits:

 

We also provide medical coding services. For more details, please visit our page.