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The claims scrubbers



By John Pulley

Scrubbing-tech sampler

Claims-scrubbing software aims to rid medical claims of errors and omissions that result in payers’ denying or underpaying claims. Among the tools used today are:

  • ClaimStaker, a Web-based application developed by Alpha II Software Solutions, scrubs medical claims for errors in ANSI 837 fields, the file format used for electronic billing of professional services. The software generates reports of problems that are likely to hamper timely and accurate payment.

  • ProVation MD simplifies the traditional method for converting physicians’ notes into medical claims. The company says its abbreviated method streamlines coding and billing procedures. In place of traditional dictation and transcription procedures, doctors use ProVation to document medical procedures at the point of care.

  • Netrics makes software that mimics human discernment and the brain’s capacity for pattern matching. The solution tackles the type of problem that arises if, for example, a clerk inadvertently enters the name Rogers instead of Rodgers on a medical claim. A purely automated system

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