All electronic claims submitted through the clearinghouse are “scrubbed” with electronic claim edits, meaning that the claim will be rejected for any missing data or any data that does not meet the carrier specific guidelines.
Rejected claims will be reviewed by GMM billing staff and the appropriate measure will be taken to ensure claim is corrected asap. Corrective action may require additional information from physician or the physicians staff. Rejected claims are tracked until the correction is made. Corrected claims will be resubmitted through the clearinghouse.
Clean claims are transmitted from the clearinghouse to the appropriate insurance carrier for claim adjudication.