Claim scrubbing is the automated review of a claim before submission to catch missing data, invalid codes, incorrect code pairings (such as NCCI edits), missing modifiers and payer-specific rules.
Every error caught by a scrubber is a rejection or denial that never happens.
Related terms
- Clean claim rate
- The share of claims that pass all edits and are accepted on the first submission.
- NCCI edits
- CMS rules that flag code pairs that should not normally be billed together.
- Claim rejection
- A claim returned before processing because of errors; it never entered adjudication.