Real-time Claim Scrubbing
With the DuxWare Claim Scrubber, you can find and fix coding errors before the payer ever sees them. What does this mean for your practice? When the payer receives your claims, your coding is accurate. More claims are paid, and turnaround time for payment is shorter. Optimize your reimbursement process effortlessly.

What does optimized coding look like with the DuxWare Claim Scrubber?

• All codes at ultimate specificity
• Your diagnoses support your procedures
• Global periods and RVUs are correctly identified
• Procedure codes are bundled correctly
• Diagnosis codes show medical necessity
• Puts all required modifiers correctly in place
• Avoid overused generic and 'catch-all' codes which means proper up-coding or down-coding

When your practice uses the DuxWare Claim Scrubber, it will:

• Help the physician get reimbursed properly with shorter turn-around time, which increases billing efficiency
• Obtain faster ROI by prompting proper coding the first time, avoiding costly denials, underpayments, and reprocessing costs
• Help the physician charge the proper Evaluation and Management code level for services rendered
• Help identify missing charges that would otherwise be lost
• Help to improve both physician and coder education with proper coding techniques
• Decrease claim denials by catching errors before claims are submitted
• Reduce your accounts receivable by prompting for necessary reimbursement information
• Increase consistency by targeting the use of proper modifiers for specific procedure and diagnosis usage
• Help your practice mirror the scrutiny that a carrier will use to review your claims
• Help you to reduce human errors and discrepancies

DuxWare Claim Scrubber uses Special Coding Edits to check claims for:

• LCD/NCD medical necessity
• Identifies starred procedures
• ICD-9 codes not at ultimate specificity
• Correct Coding Initiative (CCI) Compliance
• Sequences CPT codes in correct order based on RVUs
• ICD-9 codes that do not support a selected CPT code
• Proprietary medical necessity based upon the carrier being billed
• Identifies applicable and mandatory modifiers for selected CPT codes
• Applies CCP edits to CPT and HCPCS codes to check for bundling/unbundling errors

Other Edits Include:

• Medicare specific front-end edits
• Verifies existence of a referring physician and referring physician UPIN on radiology/lab charges
• Checks for modifier -26 on radiology charges when site of service is a hospital
• Suggests attaching hard copy claim with op reports when there are more than five surgical procedures
• Validates positive line item charge amounts
• Checks for existence of mammography certification numbers on mammography screening procedures
• Validates referring physician UPIN numbers and the existence of facility IDs for each appropriate service
• User defined edits for specific payers in your geographical area

DuxWare Claim Scrubber Compliance Features:

HCFA and the Office of the Inspector General suggest that an essential part of any effective compliance program is establishing a method of detecting, correcting, and preventing coding errors. With DuxWare^® Claim Scrubber you can ensure your claims are compliant with Medicare front-end format requirements as well as with the complete list of Correct Coding Initiative edits.

DuxWare Claim Scrubber will identify incorrect codes and data, explain the error logic, and allow you to correct mistakes before you submit the claim. The error report can be saved as compliance documentation. The process of identifying and correcting mistakes helps you learn correct coding and promotes another essential aspect of compliance: staff education. It is that simple and it works!