Claim submission and scrubbing
Claim submission is the transmission of a completed claim to the payer, and scrubbing is the rules-based check that happens before it is sent.
Follows charge entry. Feeds into rejection management.
Where practices lose money here
Preventable errors reach the payer
A claim with a missing modifier, invalid diagnosis pointer, or mismatched NPI gets rejected before it is even reviewed, adding a full cycle of delay for something that should have been caught before submission.
Secondary claims get forgotten
Secondary claims require different handling than primary claims and are one of the most commonly dropped steps when a practice is billing manually.
How we handle it
Run every claim through rules-based scrubbing for code validity, modifier logic, NCCI edits, and payer-specific formatting requirements before submission.
Route claims through the clearinghouse with payer-specific edits applied, so errors are caught before the payer ever sees them.
Submit primary and secondary claims correctly sequenced, including coordination of benefits data.
File paper claims where a payer still requires them, tracked the same way as electronic claims.
Hold submission to a 24 to 48 hour standard from charge entry completion.
What you receive
Concrete output for this step, delivered on a set schedule rather than on request.
- A daily submission report showing claims sent, held, and the reason for any hold.
- A clean claim rate tracked against the industry benchmark.
Where this sits in the cycle
This is the step where the claim actually leaves the practice. Everything before it is preparation. Everything after it depends on what was actually sent.
Questions about this step
What does "scrubbing" actually check?
Code validity, modifier combinations, NCCI edit conflicts, payer-specific field requirements, and matching between the diagnosis and procedure codes, before the claim reaches the clearinghouse.
How fast do claims go out after the visit?
Standard is 24 to 48 hours from completed charge entry, assuming coding and documentation are already resolved.
Want us to review how this is handled in your practice right now?
The free billing audit looks at claim submission and scrubbing alongside the rest of the cycle, and comes back with specific findings.