How to Scrub Claims in ElderSuite

📝 Overview

Scrub Claims is the required pre-submission step in the Claim Center. It reviews Pending claims in the working list, fills billing information from the client record where available, refreshes the pay rate when appropriate, and flags claims that still need attention.

Use Scrub Claims after attendance has been saved for the billing period and before opening Process Claims. Run Scrub & Fix, resolve every scrub error, and save the scrubbed claims before submission.

For the broader workflow from attendance through submission and reconciliation, see Adult Day Care Billing Software.

⚙ How It Works

1. Open Scrub Claims

Open Claim Center → Scrub Claims.

The screen opens on Monday through Friday of the current week with the claims for that range already listed. Change Start Date and End Date as needed and click Find to load a different period.

The claims come from saved daily attendance records. If attendance has not been saved for a service date, there is no associated claim to scrub.

Use Filter by Payment Type and Filter by Claim Status when you need to narrow the working list. These filters also narrow the claims examined by Scrub & Fix, the claims included by Print, and the claims passed to Export Claims.

2. Click Scrub & Fix

Click Scrub & Fix to review the Pending claims currently listed.

For each eligible claim, ElderSuite fills missing billing values from the client's record where available. It also refreshes the pay rate when the client's nonzero rate differs from the claim, calculates the amount when the current amount is zero, and sets or clears the claim's error flag.

Scrub & Fix does not replace a nonzero claim amount and does not create information that is not available from the claim or client setup.

The corrections remain on the Scrub Claims screen until they are saved.

3. Review Flagged Claims

Review any row that remains error-flagged after the scrub.

Highlight the row and click Edit Claim, or double-click the row, to open the claim for review.

When the claim is editable, billing staff can manually adjust the calculated Units value when needed. The normal attendance workflow calculates Units from service times; claim-level adjustment is available from Edit Claim.

After correcting an error, run Scrub & Fix again. The error flag clears only when the claim passes a subsequent scrub.

Print creates the ES3200 scrub report for the claims currently listed. Export Claims writes the current list to CSV and offers All Claims or Only Error-Free Claims.

4. Save the Scrubbed Claims

When every claim for the batch has been scrubbed successfully and no scrub errors remain, click Save & Close to store the scrubbed claim changes.

After the successful scrub is saved, continue to Process Claims for electronic submission.

✅ Important Limitations

Scrubbing is required before submission. Complete Scrub & Fix, resolve the errors, rerun the scrub until the claims are error-free, and save the results before using Process Claims.

Scrub & Fix changes only Pending claims currently shown in the working list. Claims with other statuses are skipped.

It does not replace an amount that is already nonzero.

It cannot supply an original claim number when a corrected or replacement claim requires one and none is available.

It cannot create missing client demographics or billing identifiers that are not available from the client and claim setup.

Payer-specific requirements still need to be confirmed with the payer or clearinghouse.

Scrubbed corrections are not written to the ElderSuite database until you save them.

💡 Need More Help?

For help scrubbing, correcting, printing, or exporting claims, open Ask Eddie inside ElderSuite.