Scrub Claims copies missing billing details onto Pending claims from each client record, flags what it cannot fix, and leaves a clean, searchable list ready to send.
Scrub Claims is the batch clean-up in the Claim Center. It works through Pending claims for a chosen date range, copies missing billing details from each client record, and flags anything it cannot fix so the list is clean and ready to send.
Open Scrub Claims after attendance has been entered for the period, and before those claims are processed.
This is not Reconcile Claims. Reconcile is a later step.
Open the Claim Center and click Scrub Claims. The screen opens already showing Monday through Friday of the current week, so you can start with this week's claims right away.
To load a different range, change Start Date and End Date and click Find. If nothing comes back, ElderSuite reports that no claims were found for those dates.
The claims on this screen are the attendance records for those dates. If the attendance has not been entered, there is nothing to scrub.
Filter by Payment Type and Filter by Claim Status narrow the list as soon as they change. What is showing is what Scrub & Fix examines, what Print produces, and what Export Claims writes.
Click Scrub & Fix to work through every Pending claim on the list. Nothing has to be selected first.
Scrub & Fix works Pending claims only. Claims that have already moved past Pending are left alone.
For each Pending claim, missing billing details are copied from the client record.
The Ray Rate is always refreshed from the client record, so a claim created before a rate change picks up the current rate. The amount is worked out only when it is currently zero, so a figure already on the claim is left alone.
Any claim the scrub cannot completely fix is flagged so you can see which rows still need attention.
The corrections stay on this screen. Nothing is written until you click Save & Close.
After a scrub, look for the error flag on each row. A mark means the claim still has a problem.
Highlight the row and click Edit Claim to open it in the Health Insurance Claim Form. Double-clicking the row does the same thing.
Print produces the scrub report for whatever is currently listed. An X prints against each flagged claim. The report is ES3200.
Export Claims writes the listed claims to a comma separated value file. Choose Only Error-Free Claims to leave out every flagged row. That file stays on the computer.
Click Save & Close to write the corrected claims. If Attendance & Transportation Records, Meal Records, or Reconcile Claims are open, they are refreshed with the saved values.
Scrub & Fix works Pending claims only.
It does not replace an amount that is already on the claim.
It cannot supply an original claim number for a resubmission that is not Original.
It cannot invent units—units come from the attendance record.
It cannot invent a date of birth, a physical address, a city, or a zip code.
Some payment types skip a diagnosis code, a place of service, a service code, or insured ID details.
The corrections from a scrub stay on this screen until you click Save & Close.
If you close without saving, the filled-in values are discarded.
Find, Print, and Edit Claim will ask about unsaved corrections first. Answer Yes when you want the scrub to stick.
For step-by-step assistance, click Ask Eddie from within ElderSuite.
ElderSuite is adult day care software for attendance, Medicaid billing, nursing documentation, and CACFP. You can try it free for 30 days.
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