Claims Scrubbing

Finiti's claim submission timelines are aimed at under 12 hour submissions following clinical encounters. We diligently follow-up with providers to ensure timely chart closure.

Finiti has a proactive approach to ensure claims scrubbing is complete and as accurate as possible. Each claim type has a defined clinical documentation matrix that is diligently followed up to ensure all data is available for an accurate claim submission in first go.

The claim processing cycle begins with the submission of a claim by a healthcare provider to a payer. The claim contains information about the patient, the services provided, and the charges for those services. The payer then reviews the claim to ensure that it meets all the necessary requirements for reimbursement, such as verifying the patient's eligibility and the medical necessity of the services provided.

Once the claim has been reviewed, the payer will either approve the claim and issue payment or deny the claim and provide an explanation of benefits (EOB) detailing the reasons for denial. If the claim is denied, the healthcare provider can either appeal the decision or adjust the claim and resubmit it for review.

We have extensive experience with a wide range of EMR systems, billing software and electronic claim submission systems. All claims are typically submitted to a clearing house. Rarely clearing house may reject claims for insufficient information. Finiti claims team immediately rectifies and ensures timely claim submission.