What is 'claims scrubbing'?

• A. The pre-submission review of claims to correct errors and avoid rejections or denials.
• B. A post-payment penalty process.
• C. A process to verify provider licensing.
• D. A method to encrypt claims data.

Answer: (A)

Claims scrubbing is the pre-submission review of claims to correct errors and avoid rejections or denials. It uses automated checks to verify that codes, dates, patient details, and other payer requirements are correct before a claim is sent. By inspecting CPT/ICD codes, modifiers, billing units, dates of service, and required fields, the scrubber flags issues that would cause a claim to be rejected or paid incorrectly. The goal is to produce a clean claim that adheres to payer rules and formatting, speeding reimbursement and reducing follow-up work. This is different from post-payment processes that handle issues after submission, and it isn’t about verifying provider licensing or encrypting data—the focus is on the accuracy and completeness of billing information before submission. Many practices use a clearinghouse or billing software to perform this pre-submission scrub to minimize denials.