Claim Scrub Agent

The best denial is the one that never happens. The Claim Scrub Agent reviews every claim before it goes out the door — checking 800+ rules for coding errors, missing information, payer-specific requirements, and medical necessity. It catches the mistakes that cause 80% of preventable denials, so claims go out clean the first time.

94%
First-pass clean claim rate
800+
Validation rules
80%
Preventable denials eliminated

How It Works

Four steps from setup to results — no IT project required.

1

Ingest claims

The agent pulls claims from your PM or billing system as they're ready for submission — no manual trigger needed.

2

Run 800+ validation rules

Each claim is checked against coding rules, payer-specific requirements, NCCI edits, and medical necessity guidelines in milliseconds.

3

Surface errors with fixes

When an error is found, the agent doesn't just flag it — it tells your team exactly what's wrong and suggests the correction.

4

Release clean claims

Only claims that pass all checks are released for submission. Your team reviews flagged claims, applies fixes, and re-runs validation in seconds.

What It Does

Every capability included, out of the box.

800+ pre-submission validation rules
Payer-specific rule sets for major payers
LCD/NCD medical necessity checks
Modifier validation and correction
NCCI edit detection
Real-time feedback with actionable fix suggestions

Common Use Cases

Pre-submission claim validation for all payers
Payer-specific scrubbing for high-volume payers
NCCI edit checking for surgical claims
Medical necessity validation for high-risk procedures

Works With Your Stack

AT
athenahealth
KA
Kareo
AD
AdvancedMD
WA
Waystar
EC
eClinicalWorks
NE
NextGen

Frequently Asked Questions

Real questions from practices evaluating this agent.

Most PM systems have basic scrubbing. The Claim Scrub Agent applies 800+ rules including payer-specific logic, NCCI edits, and medical necessity checks — far beyond what built-in scrubbers cover. It also suggests fixes, not just errors.

Ready to deploy Claim Scrub Agent?

Talk to our team about how this agent fits your practice. 14-day deployment, no long-term contracts, 30-day money-back guarantee.

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