- High rate of validation of subscriber and provider information
- Aliasing and fuzzy matching to allow for misspellings, and variations on names and locations
- User-friendly exception management tools
- High rate of auto-preadjudication
- Clean claims are expedited through the claim cycle while problems are identified early on
- Thorough scrubbing means much faster turn-around-time and fewer errors
The objective of the ClaimsBridge scrubbing services is to maximize our client’s auto-adjudication or auto-pre-pricing rates.
To provide the most accurate editing and validation, ClaimsBridge uses industry standard code sets and HIPAA specifications to validate claim format and content. ClaimsBridge uses artificial intelligence techniques to automate the validation processes. Claims that cannot be automatically processed are handled through user-friendly manual exception management queues in the Web Portal.
Subscriber & Provider Matching
Client provider and eligibility data can be used to match incoming claims. The matching algorithms follow each client’s specific business rules. Under this scenario, when a match is made, demographic data can be overwritten in order to deliver a readily adjudicatable claim. All changes are tracked in the audit trail and can be easily viewed.
The fully customizable ClaimsBridge export module is capable of adjusting claim markings to fit your particular needs. These mutually agreed upon codes and values are usually used to speed claim processing through your systems.