Claims scrubbing and submission
Eligibility Hub checks every professional (837P) and dental (837D) claim before it goes out, then sends it to payers through its clearinghouse. Sending is idempotent, so a claim is never billed twice. Acknowledgments are tracked, rejections come back with plain-English reasons, and corrected or voided claims are handled.
At a glance
- Availability
- Launching after setupLaunches for a practice after its setup steps. Production sending is switched on per practice after agreements and approval.
- Part of the cycle
- Bill: scrub and submit claims
- What it costs
- Included in the full service at 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included.
- Your practice
- Complete and sign visit notes
Who does what
Eligibility Hub does
- Scrub and submit every claim, then track acknowledgments
- Fix rejections and resubmit
- Handle corrected and voided claims
- Report clean-claim and rejection rates by code and payer
Your practice does
- Complete and sign visit notes
- Capture charges
What is checked before a claim is sent
Claim checks
- Payer ID, frequency code, billing and rendering NPIs, and incident-to rules
- Modifiers where they apply, for example KX, JW or JZ
- Units per square centimeter for skin substitutes, and the service facility
- CCI and MUE edits, timely filing limits and eligibility on the date of service
What you see after
- Clearinghouse and payer rejections with plain-English reasons
- Clean-claim and rejection rates by code and payer
Limits worth knowing
- We cannot write back into a practice-management system we only have read access to.
- Clean claims improve the odds of payment. Payers still decide.
Questions
Which claim types do you send?
Professional claims (837P) and dental claims (837D).
How do you prevent double billing?
Sending is idempotent: each claim has one identity, so a retry cannot create a second submission.
What happens when a claim is rejected?
The rejection comes back with a plain-English reason. We fix what is ours to fix, resubmit, and tell you when we need something from the chart.
Is claims submission available now?
It is built and launches for each practice after setup: agreements, practice setup, shadow mode and enrollment come first.
Review the scope before you begin
The full service is 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included. See pricing for how the fee is calculated.
Last updated 2026-10-06