Scrubber Errors-How to Correct and Rebuild Claim

If the Scrubbing process finds a claim with errors/incomplete information, a Scrub Error message will pop up and the claim will automatically be moved to the On Hold section of Claims Manager.

This lesson will describe the errors and list the steps to correct the error(s). The Claim will then have to be Rebuilt to apply the corrections, and Scrubbed again. When the claim has passed the scrubbing process, it will be automatically moved to the Ready to Submit section.

Note: Edits/Corrections will not be applied to claims unless the Rebuild process is performed.

Scrub Errors

Claim #1327 was scrubbed and rejected because it was missing a diagnosis code for CPT code 85025.

1.  Click the OK button in the message box.

2. In the On Hold section of the Claims Manager, Double Click anywhere on the claim line to open Patient Account.

Patient account will open to the Claims tab with the active claim shown in the bottom section. Corrections can be made by clicking on any of the tabs, depending on what the scrub error indicates.

After corrections are made, Close the Patient Account, return to Claims Manager and Rebuild claim to apply changes.

At least one diagnosis must be entered for the charges: No Diagnosis entered for 85025

1. Double click on the line item that's missing info to open Charge Details dialog

At least one diagnosis must be entered for the charges: No Diagnosis entered for 85025 (continued)

At least one diagnosis must be entered for the charges: No Diagnosis entered for 85025 (continued)

2. Click Add Code in Diagnosis Codes section

3. Type code or use drop down to search by code or description

4. Click Select and Save

Close patient account and return to Claims Manager. Select claim from On Hold section and click Rebuild.

The Primary insured is missing part or all of their demographics

The Primary insured is missing part or all of their demographics

Verify insured info

1. Find the claim getting rejected in the On Hold section of Claims Manager and Double Click inside the grid to open Patient account. Click the Insurance tab.

2. Click View next to the insurance company getting the error

3. Check each field in the Insured Information section and verify that it matches information exactly as it appears on insurance card, including the Patients relation to insured.

Return to Claims Manager and Rebuild claim to apply changes.

Primary Insurance Company Missing Data

Primary Insurance Company Missing Data

Check Insurance Company setup

1. Find the claim getting rejected in On Hold section of Claims Manager and find the Payer name-Primary column or Secondary column, depending on filing status

2. Go to Tools -> Insurance Company.

3. Find the Insurance Company/Payer within the list and Click the Edit Icon.

4. Add missing info.

5. Click OK

 

For step by step Insurance Company setup instructions, click here

Return to Claims Manager and Rebuild claim to apply changes.

 

Secondary Insurance Company Missing Data

Secondary Insurance Company Missing Data

Check Insurance Company setup

1. Find the claim getting rejected in On Hold section of Claims Manager and find the Payer name-Primary column or Secondary column, depending on filing status Go to Tools -> Insurance Company.

2. Find Insurance Company in Insurance Company Manager and Click the Edit Icon.

3. Add missing info.

4. Click OK

                       

For step by step Insurance Company setup instructions, click here

Return to Claims Manager and Rebuild claim to apply changes.

 

The Provider is missing part or all of their information

The Provider is missing part or all of their information

Verify Rendering Provider information in Provider Manager

1. Find the claim getting rejected in the On Hold section of Claims Manager and Check for Provider name in the Provider column.

 

2. Go to Tools -> Provider Manager and verify correct info is entered in all fields.

3. Add missing data.

4. Verify Provider is linked to Billing/Group information.

5. Verify Signature is added.

6. Click Update.

If there is not a Provider shown in the Provider Column, see next step

 

The Referring provider is missing part or all of the information

The Referring provider is missing part or all of the information

Verify Referring Physician info is entered correctly in Contacts

1. Find the claim getting rejected in the On Hold section of Claims Manager and Double Click inside the grid to open Patient account. Click the Demographics tab.

2. Check the name of the Referring Provider.

3. Go to Tools -> Contacts and select the Referring Provider from the list. Double click to Edit Contact Information.

4.  Verify Provider information is included in each required field.  

5. If additional provider IDs are required, add the insurance company requiring the ID and enter that information.

6. Click OK to save information.

Return to Claims Manager and Rebuild claim to apply changes.

The Provider is missing all or part of the signature

The Provider is missing all or part of the signature

Verify Rendering Provider Signature is loaded

1. Find the claim getting rejected in the On Hold section of Claims Manager and check the Physician column to find the name of the Rendering Physician.

2. Go to Tools > Provider Manager and select that physician from the list of Providers.

3. Click on the Signature tab and make sure signature is selected. (See Provider Manager setup in Billing Maintenance)

4. Click Update.

Return to Claims Manager and Rebuild claim to apply changes.

 

The Facility is missing part or all of its information

The Facility is missing part or all of its information

Check Facility Setup

1. Find the claim getting rejected in On Hold section of Claims Manager and Double Click inside the Grid to open Patient Account.

2. From the Claims tab, make sure the rejected claim is displayed in Claim Details and Double Click to open the Charge Details.

3. Check the Facility in the Misc. Details section of Charge Details dialog as shown in the previous step.

4. Go to Tools -> Manage Facilities and select the Facility from the list.

5. Click the Edit icon.

 

Facility Information

Facility Information

6. Verify required information is included in each field. (Include 9 digit Zip Code)

7. If Additional IDs are required, click the Additional IDs tab and enter required information.

7. Click Update to save changes.

Return to Claims Manager and Rebuild claim to apply changes.

 

Invalid State

Invalid State

Patient is missing part or all of their demographics: Invalid State

Primary Insured: Invalid State

Secondary insured: Invalid State

In the On Hold section of the Claims Manager, find the claim with the error and double click to open Patient Account.

1. Click on the Demographics tab.

2. In the Address section, correct the state format. It should be a two digit, all CAPS, valid state.

3. Click on the Insurance tab.

4. In the Primary Insurance section, click the View button.

5. In the Insured Information section, correct the State format.

6. Click Save.

Repeat for the Secondary Insurance Policy, if applicable. Claim must be Rebuilt to apply changes.

Note: This scrub error can also be seen if there is an invalid state format used in Manage Facilities, Insurance Company setup, Manage Groups, and all areas where  the state is required.