Accurate Charge Entry
We reconcile daily appointment schedules against signed EHR encounter notes and superbills—capturing every billable CPT, HCPCS, unit, and fee schedule charge.
Electronic Medical Claim Submission & Scrubbing Services for Healthcare Practices
Doc Flow RCM delivers 24-hour charge entry, multi-layer claim scrubbing, electronic EDI 837P & 837I claim submission, and same-day 277CA clearinghouse rejection resolution—achieving a 99.2% first-pass clean claim rate for practices across the USA.
- ✓ 24-Hour Turnaround from Signed Encounter to Electronic Claim Submission
- ✓ Multi-Point Claim Scrubbing for NCCI Edits, LCD/NCD Rules & Modifiers
- ✓ Same-Day 999 & 277CA Clearinghouse Rejection Resolution
- ✓ Primary, Secondary & Tertiary Crossover Billing With Medical Attachments
99.2%
First-Pass Clean Claim Rate
< 24 Hrs
Charge Entry & Submission SLA
Same-Day
277CA Rejection Resolution
14 Days
Average Commercial Reimbursement
End-to-End Claim Submission Support From Superbill Audit to Payer Acceptance
A single demographic typo, missing prior authorization number, or unbundled modifier can delay your reimbursement by weeks. We scrub and validate every claim before transmission.
Pre-Submission Scrubbing
Every claim undergoes automated and manual scrubbing for NCCI bundling edits, MUE unit limits, ICD-10 medical necessity pointers, and payer-specific formatting rules.
EDI 837P & 837I Transmission
We transmit CMS-1500 (837P Professional) and UB-04 (837I Institutional) claim batches daily across all national clearinghouses and direct payer portals.
277CA Rejection Fixes
We monitor clearinghouse 999 and payer 277CA acknowledgment reports daily—correcting and re-transmitting any rejected claims on the exact same business day.
Secondary & COB Billing
When automatic Medicare/Medicaid crossovers don't trigger, we promptly submit secondary and tertiary claims with attached primary EOBs and coordination of benefits data.
Clinical Claim Attachments
For unlisted codes, surgical modifiers (22, 62), or high-dollar implants, we submit operative reports, invoices, and medical records alongside the initial claim.
Workers’ Comp & Auto/PIP
We manage specialized Workers’ Compensation, Auto/No-Fault (PIP), VA/Tricare, and out-of-network paper CMS-1500/UB-04 submissions with complete case documentation.
Zero Missing Charges
We run weekly missing-charge and unsigned-note audits to ensure zero patient encounters slip through the cracks unbilled before timely filing windows close.
How Our 24-Hour Claim Submission Process Works
We transform signed clinical encounters into clean, payer-accepted electronic claims within 24 hours—accelerating your reimbursement cycle from day one.
01
Encounter & Superbill Sync
We pull daily completed appointments, signed progress notes, and superbills directly from your EHR system.
02
Charge Entry & Coding Check
CPT, HCPCS, ICD-10 diagnosis pointers, units, NDC drug codes, and POS codes are verified for accuracy.
03
3-Point Claim Scrubbing
Claims pass through EHR edits, clearinghouse NCCI/LCD scrubbers, and manual audit checks for prior auth & referrals.
04
Electronic 837 Transmission
Clean 837P/837I claim batches are transmitted to commercial, Medicare, and Medicaid payers within 24 hours.
05
999 & 277CA Tracking
We verify clearinghouse batch acceptance (999) and individual payer claim acceptance (277CA) reports daily.
06
Same-Day Rejection Rework
Any front-end clearinghouse or payer scrub rejection is corrected and re-submitted within the same business day.
What We Scrub & Validate Before Every Claim Is Submitted
Submitting claims without rigorous pre-submission scrubbing leads to avoidable 277CA rejections and CO-16/CO-97 denials. Our 4-pillar audit catches errors before payers ever see them.
1. Patient Demographics & Payer ID Accuracy
- ✓Exact match of patient name, DOB, gender, and subscriber relationship
- ✓Validation of active Member ID format, group number, and electronic Payer ID
- ✓Verification of primary vs. secondary payer order (Medicare Advantage & COB)
- ✓Confirmation of accident indicators, onset dates, and workers' comp claim numbers
2. Coding, Modifiers & NCCI Edits
- ✓CPT/HCPCS to ICD-10-CM diagnosis pointer linkage and specificity checks
- ✓National Correct Coding Initiative (NCCI) procedure-to-procedure bundling checks
- ✓Medically Unlikely Edits (MUE) unit validation and bilateral modifier (50, LT/RT) checks
- ✓Proper application of Modifiers 25, 26, TC, 59, XU, QW, and JW/JZ drug waste modifiers
3. Provider NPI, Taxonomy & Facility Data
- ✓Rendering, Billing, Supervising, and Referring Provider NPI validation (Box 17, 24J, 33)
- ✓Payer-specific provider taxonomy code and CLIA certification number verification
- ✓Accurate Place of Service (POS 11, 10, 02, 21, 22, 24) and facility address matching
- ✓Incident-to and mid-level (NP/PA) supervising physician billing rule compliance
4. Prior Auth, Referrals & Special Fields
- ✓Placement of approved Prior Authorization and PCP referral numbers in Box 23
- ✓11-digit National Drug Code (NDC), unit of measure, and quantity validation for J-codes
- ✓Global surgical period screening to prevent post-op E/M rejections
- ✓Attachment of operative reports, invoices, or primary EOBs when required by the payer
How Clean Claim Submission Accelerates Your Reimbursements & Reduces A/R Days
Every rejected or denied claim costs an average of $25 to $45 to rework and delays payment by 30+ days. Getting claims right on the first submission protects your bottom line.
Rushed / Unscrubbed Submissions
Why practices suffer from slow cash flow and high rejection rates
- Claims are batched and pushed out without checking NCCI edits or payer-specific modifier rules
- Clearinghouse 277CA rejections sit unnoticed in portals for weeks without being reworked
- Missing Box 23 prior authorization numbers or Box 17 referring NPIs trigger instant denials
- Unbilled encounters and unsigned chart notes pile up without weekly reconciliation
- Secondary claims fail to go out after primary payment, leaving 20% coinsurance uncollected
Doc Flow RCM Clean Claim Submission
99.2% first-pass acceptance with 24-hour submission speed
- Every charge is scrubbed against NCCI, MUE, LCD/NCD, and payer edits before transmission
- Daily 999 and 277CA monitoring ensures 100% of rejections are fixed the same business day
- Auth numbers, referrals, NDC drug codes, and CLIA numbers are verified prior to billing
- Daily schedule-to-claim reconciliation ensures zero missed or unbilled encounters
- Prompt secondary/tertiary claim submission with attached primary EOBs for full collection
Why Medical Practices Choose Doc Flow RCM for Claim Submission
We combine certified medical billers, advanced clearinghouse rules engines, and strict daily tracking to keep your revenue flowing without bottlenecks.
99.2% Clean Rate
First-Pass Acceptance
While the industry average clean claim rate hovers around 75%–85%, our pre-submission audit delivers a 99.2% first-pass acceptance rate.
24-Hour SLA
Daily Claim Transmission
We don’t hold claims for weekly batches. Signed encounters are entered, scrubbed, and submitted electronically within 24 business hours.
All Major EHRs
Direct EHR & PM Workflow
We work natively inside Epic, Athenahealth, eClinicalWorks, Kareo/Tebra, AdvancedMD, NextGen, DrChrono, and Practice Fusion.
All Clearinghouses
277CA Rejection Mastery
Our billers manage daily rejection queues across Waystar, Availity, Office Ally, Trizetto, and Change Healthcare with zero backlog.
Charge Audit
Missing Encounter Logs
Every week, we provide a clean reconciliation report matching your appointment schedule against submitted claims so no visit goes unbilled.
100% HIPAA Secure
Compliant & Transparent
All claim submissions, electronic attachments, and clearinghouse transmissions are executed under strict HIPAA-compliant security protocols.
Medical Specialties We Support Across the United States
Customized CMS-1500 (837P) and UB-04 (837I) claim scrubbing rules tailored to the unique coding, modifier, and attachment requirements of your specialty.
Primary Care & Family Medicine
Interventional Pain Management
Psychiatry & Behavioral Health
Orthopedics & Spine Surgery
Cardiology & Vascular Clinics
Ambulatory Surgery Centers (ASC)
Gastroenterology & Endoscopy
Radiology & Diagnostic Imaging
Physical, Occupational & Speech Therapy
Neurology & Neurosurgery
Urgent Care & Walk-In Clinics
Multi-Specialty Medical Groups
Frequently Asked Questions About Claim Submission Services
Clear answers on how Doc Flow RCM scrubs, submits, and tracks your medical claims from encounter to payment.
Q1. How fast do you submit claims after a provider signs the encounter note?
We submit claims within 24 business hours of encounter completion. Our team pulls signed superbills and chart notes daily, performs charge entry and 3-point claim scrubbing, and transmits clean 837 electronic batches the very same day.
Q2. Do you handle both CMS-1500 (837P) and UB-04 (837I) claim submissions?
Yes. We manage both CMS-1500 (EDI 837P) professional claims for physician practices and clinics, as well as UB-04 (EDI 837I) institutional facility claims for Ambulatory Surgery Centers (ASCs), behavioral health facilities, and diagnostic centers.
Q3. What happens if a claim is rejected by the clearinghouse or payer front-door?
We monitor 999 batch acknowledgments and 277CA payer claim status reports every single morning. If a claim rejects due to a subscriber ID mismatch, referring NPI issue, or formatting edit, our team corrects and re-submits it within the same business day so your reimbursement is never delayed.
Q4. How do you ensure no scheduled appointments go unbilled?
We perform daily and weekly Schedule-to-Claim Reconciliation. By comparing your EHR appointment calendar against created superbills and transmitted claims, we flag any missing charges or unsigned provider notes so 100% of your rendered services are billed on time.
Q5. Do you also submit secondary claims and claims requiring medical records?
Absolutely. As soon as the primary payer posts payment, we verify whether an automatic crossover occurred. If not, we submit the secondary or tertiary claim electronically or on paper with the primary EOB attached. We also attach operative notes, clinical records, and invoices for claims requiring pre-payment review.
Ready to Achieve a 99.2% Clean Claim Rate & Get Paid Faster?
Partner with Doc Flow RCM for 24-hour charge entry, multi-point claim scrubbing, and same-day rejection resolution across all payers and EHR platforms.