Claim Scrubber software: the benefits for healthcare providers

Key takeaways:

• Claim scrubbing is a critical part of claims management, designed to improve claim accuracy and catch errors before submission.
• Errors on claims are a leading cause for denials and reworks are costly and time-consuming.
• Organizations that adopt claim scrubber software, like Experian Health’s Claim Scrubber, typically see few denied claims and maximize reimbursements.

Preventing claims denials is a top priority for 82% of healthcare organizations. Claim denial rates are climbing, and 68% of providers say submitting “clean claims” is more challenging than a year ago, per the latest Experian Health’s State of Claims 2025 data. Claim scrubber technology, like Experian Health’s Claim Scrubber, can help healthcare providers submit clean claims from the start.

Here’s what healthcare organizations need to know about using claim scrubbers to catch errors up front, minimize costly reworks and speed up reimbursements.

What is claim scrubbing in healthcare?

Claims scrubbing in healthcare is the process used by providers to increase claim accuracy and reduce errors, so that “clean claims” are submitted for reimbursement. Claim scrubbing is a critical part of the healthcare revenue cycle and a key component of an organization’s overall claims management process.

To minimize the risk of denials and costly rework, administrative staff typically review claims for accuracy before submission. Several areas of each claim are inspected and updated as needed, including patient information, coding, payer requirements and billing details.

Why are claim scrubbers important?

Claim scrubbers are important tools for healthcare organizations and are used to help teams submit clean and accurate claims the first time. These tools significantly limit the chance of a mistake slipping through due to human error or outdated information. With claim scrubbers, undercharges and denials are reduced; billing and payments are more timely; and providers see improved cash flow.

Experian Health’s Claim Scrubber, for instance, not only reduces the amount of claims errors but also streamlines the entire claim scrubbing process through automation. Claim Scrubber is built to seamlessly complement Experian Health’s other claims processing solutions, including ClaimSource® and Denial Workflow Manager.

What errors does a claim scrubber catch?

Claim scrubbers are designed to identify and correct mistakes that may potentially lead to a denial. Missing claims data is the top reason a claim is denied, and more than a quarter of denials result from inaccurate or incomplete data collected at patient intake.

A claim scrubber uses technology to cross-check claims for accuracy and to verify that all information is not only correct, but complete before submission. For example, Experian Health’s Claim Scrubber solution uses automation to catch potential issues, like insurance information errors and billing code mistakes, before claims reach the payer.

What’s the difference between a claim scrubber and denial management software?

A claim scrubber is designed to catch errors on claims before they are submitted, to make sure all information is accurate and complete. On the other hand, denial management software, such as Experian Health’s Denial Workflow Manager, is used by providers to manage denied claims after they are submitted.

As technology evolves, organizations are also rapidly adopting new denial management solutions that leverage artificial intelligence (AI) to prevent denied claims before they start and process denials more efficiently.

On the front end, tools like Experian Health’s Patient Access Curator™ (PAC) use AI to automatically check and verify patient demographic information such as insurance details and eligibility. Experian Health’s AI Advantage™ works across two key stages of denial management to predict claim outcomes mid-cycle and pushes urgent tasks to the front of the queue.

Together, PAC and AI Advantage form a closed-loop system that helps providers reduce denials, increase reimbursements and reduce administrative burden.

How does Claim Scrubber work?

Experian Health’s Claim Scrubber is designed to consistently and reliably help healthcare staff produce clean and accurate claims that are more likely to be approved by payers. Claim scrubbing occurs within 2.7 to 3.0 seconds, ensuring speedy transaction processing that leads to faster reimbursements — even in batch mode.

Claim Scrubber operates on a VPN connectivity feature that ensures secure and rapid responses for real-time integrations. And since the solution is an Experian Health cloud-based application, providers can reap Claim Scrubber’s full benefits without the need for downtime, managing servers or regular maintenance.

Here’s a closer look at how Claim Scrubber works:

• Step 1: Claim Scrubber meticulously analyzes each line of every pre-claim to verify accurate coding and information before submission to the claims clearinghouse.
• Step 2: After completing the analysis, Claim Scrubber provides general and payer-relevant edits that pinpoint incorrect code combinations or other issues that could lead to claim denial.
• Step 3: Edits are stored within the Claim Scrubber portal and can be conveniently accessed by users from their PMS and HIS.
• Step 4: Reasons for flagging a claim are detailed, so users can make appropriate corrections before submission. (Users can make edits in alignment with payer policies, using Experian Health’s comprehensive database of commercial payer policies and content.)
• Step 5: Claim Scrubber identifies when the billed amount is less than the payer-allowed amount, helping health systems catch and correct undercharges.

How does Claim Scrubber help improve claims management?

Experian Health’s Claim Scrubber provides revenue cycle decision-makers and their teams with numerous benefits to help improve claims management.

• Optimizes claims processing by identifying potential coding and billing errors upfront.
• Ensures error-free claims submission to payers or clearinghouses.
• Prevents undercharges and underpayment.
• Increases first-time pass rates and prevents costly, time-consuming rework and rebilling that may result in a second rejection.
• Enables compliance with rapidly evolving price transparency rules by staying updated on coding variances.

The bottom line: What can healthcare leaders expect for the future of claims scrubbing?

Payer rules are rapidly evolving, along with industry regulations, and rising denial rates show no signs of receding. To keep up, it’s imperative for revenue cycle leaders to submit the cleanest claims possible—the first time. With the right claims scrubbing technology in place, like Experian Health’s Claim Scrubber, healthcare organizations will be better positioned to tackle the denial spiral head-on, boost cash flow and maximize revenue on every claim for years to come.

See how Experian Health’s Claim Scrubber is helping healthcare organizations submit clean, thorough claims and get paid faster and more accurately.