Revenue cycle

It tells you which box is wrong.

Validation runs before the claim leaves, highlights the exact field that will get it kicked back, and says why in plain language — not a rejection code you have to look up.

See what it costs

Behavioral health rules included. Not a generic medical scrubber.

Before it leaves

Not a rejection code. The box, and the reason.

Clearinghouse rejections arrive as a code and a claim number, days later, to someone who has to reconstruct what went wrong. Scrubbing runs on the claim in front of you and points at the field.

CMS-1500 · pre-submission checkAlvarez, R. · Aetna
Box 21 · DiagnosisF11.20
Box 24A · Date of service07/14/26
Box 24B · Place of service02
Box 24D · CPT90837 · 95
Box 24F · Charges$168.40
Box 24G · Units1
Box 23 · Prior authorizationA-88213 — expired 07/01/26
Box 33 · Billing NPI1932●●●●●●
Box 31 · Rendering providerJ. Reyes, LCSW
Box 32 · Service facilityHarbor Point Recovery
Taxonomy · rendering101YM0800X — valid for this payer
1 issue. The date of service falls outside authorization A-88213. Extend the authorization or reassign the session before submitting.

The rule set

Behavioral health edits, not a generic medical scrubber.

Most scrubbing engines were built for medical claims and bolted onto behavioral health afterwards. These are the categories that actually decide whether a BH claim pays.

Authorization matching

Date of service inside the authorized window, and units within the authorized amount.

Credential & taxonomy

Rendering provider licensed, enrolled with that payer, and billing under a taxonomy the payer accepts.

Code and modifier pairs

Telehealth modifiers, group codes, and per-diem revenue codes checked against payer rules.

Level-of-care consistency

The code billed matches the level of care the patient was actually admitted to that day.

Documentation state

The supporting note exists and is signed. Unsigned encounters do not leave as claims.

Demographic and payer data

Member ID format, subscriber relationship, and coordination of benefits order.

The real cost

A rejected claim gets touched two or three more times.

The rejection itself costs nothing. The staff hours to decode it, correct it, resubmit it, and follow up on it are the expense — and they recur on every claim that leaves with the same mistake in it.

0portal visits to decode a code

Questions

Common questions.

What does claim scrubbing check before a claim is submitted?

Six categories of behavioral-health edits: authorization matching (date of service inside the window, units within the amount), credential and taxonomy validity for that payer, code and modifier pairs, level-of-care consistency, documentation state, and demographic and payer data. Unsigned encounters do not leave as claims.

How is this different from a clearinghouse rejection?

A clearinghouse sends back a code and a claim number days later to someone who has to reconstruct what went wrong. Scrubbing runs on the claim in front of you, highlights the exact field — for example a date of service outside the authorized window — and says why in plain language, so there are zero portal visits to decode a code.

Is this a generic medical scrubber?

No. Most scrubbing engines were built for medical claims and bolted onto behavioral health afterwards. These edits — telehealth modifiers, group codes, per-diem revenue codes, level-of-care consistency — are the ones that actually decide whether a behavioral health claim pays.

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