Claim denials are a persistent challenge in healthcare revenue cycles, often caused by coding errors, medical necessity requirements, or payer-specific formatting issues, leading to time-consuming rework. As the industry evolves, healthcare organizations increasingly rely on claim scrubber software to reduce denials, speed up reimbursements, and maintain compliance.
Here are the top claim scrubber software solutions for 2025, and their financial impact on overall revenue cycle management. Explore key features, benefits, and tips for selecting the right tool for your practice or organization, helping you optimize workflows and protect your revenue.
Top 10 claim scrubber software for 2025
1. Aptarro
2. AdvancedMD
3. Optum
5. PrognoCIS
6. Waystar
8. TELCOR
9. NikoHealth
10. Shavara
Claim scrubbing is the process of reviewing and validating medical claims before submission to insurance payers. The goal is to identify and correct errors (such as incorrect codes, missing information, or formatting issues) that could lead to claim denials or delays in payment.
The table below outlines the core processes in claim scrubbing with examples.
| Scrubbing Process | Description | Example |
| Code Validation | Ensuring that diagnosis and procedure codes are accurate and compliant with current standards. | Verifying that ICD-10 and CPT codes match the patient's diagnosis and procedure. |
| Payer Compliance | Checking that the claim adheres to specific requirements set by the insurance payer. | Confirming that all required fields are completed according to payer guidelines. |
| Error Detection | Identifying common errors, such as missing modifiers or incorrect patient information. | Flagging claims with missing modifiers or mismatched patient demographics. |
| Claim Formatting | Ensuring that the claim is formatted correctly for electronic submission. | Verifying that the claim meets the formatting standards of the Electronic Data Interchange (EDI). |
Claim scrubbing is a critical step in revenue cycle management, helping prevent claim denials and ensuring timely reimbursement. By reviewing claims for coding errors, missing information, and payer-specific rules, organizations ensure submissions are accurate and complete.
This process reduces rework and speeds up the revenue cycle, supporting steady cash flow and more efficient operations. Clean claims mean fewer corrections, less administrative burden, and faster reimbursements for providers.
Beyond financial benefits, claim scrubbing also safeguards regulatory compliance. Accurate claims protect providers from audits and penalties while promoting transparency and accountability in billing practices.
Claim scrubber software is a digital solution designed to automate and enhance the claim scrubbing process. By using built-in rules, AI, and integrations with billing and EHR systems, this software identifies errors, flags compliance issues, and provides suggestions for correction before claims are submitted.
The table below highlights how claim scrubber software manages key processes compared with manual methods.
| Claim Scrubbing Process | Managed Manually | Managed with Claim Scrubber Software |
| Code Validation | Coders manually verify CPT/HCPCS/ICD codes; mistakes are frequent. | Automated code validation reduces errors and ensures proper coding. |
| Payer Rule Compliance | Staff manually check payer-specific rules; time-consuming. | Built-in payer rules and alerts prevent non-compliant claims. |
| Duplicate Claim Check | Duplicate detection is prone to oversight. | Software automatically identifies duplicate claims and flags them. |
| Error Detection & Correction | Manual review catches only some errors. | AI-powered tools detect inconsistencies, missing fields, and formatting issues in real time. |
With claim scrubber software, healthcare teams can focus on higher-value tasks while minimizing denials, rework, and compliance risks. By automating routine claim reviews and validation processes, staff spend less time manually checking each claim and more time addressing complex cases or optimizing revenue cycle strategies.
Automation also accelerates claim submission, ensuring that clean claims reach payers faster, which supports more predictable and efficient cash flow management. Additionally, centralized reporting and analytics provide actionable insights into claim patterns, error trends, and revenue opportunities, empowering administrators to make data-driven decisions that enhance overall operational efficiency.
Aptarro's RevCycle Engine is a comprehensive, AI-powered solution that combines claim scrubbing with advanced analytics for optimal revenue performance. It offers automated code suggestions, real-time compliance checks, and seamless integration with EHR and PMS systems, helping healthcare organizations reduce errors and improve first-pass claim acceptance.
Beyond scrubbing, its robust reporting tools provide actionable insights into edit performance, denial trends, and workflow inefficiencies. By highlighting areas for improvement, Aptarro enables administrators and coders to proactively address potential issues, streamline processes, and maximize revenue cycle efficiency across the organization.
Discover how Aptarro RevCycle Engine can transform your claims workflow—request a demo today to see it in action.
AdvancedMD's Claim Inspector guarantees a clean claim acceptance rate of 95% or better. It automates the scrubbing process and quickly identifies unbilled items, helping reduce manual errors.
Optum's Claim Scrubber provides real-time compliance alerts and guides coders in selecting the correct codes with minimal effort. Its advanced analytics offer detailed insights into revenue impact and workflow efficiency. Large practices and hospitals benefit from its scalable design and intuitive interface.
Experian Health's Claim Scrubber helps reduce undercharges and denials before claims are submitted. Automated solutions optimize staff time, improve cash flow, and reduce administrative burden.
PrognoCIS' claim scrubber allows staff to submit accurate medical claims while decreasing follow-up inquiries. By streamlining the billing process, it increases revenue and improves operational efficiency. Staff can quickly identify and correct issues without slowing down the workflow.
Waystar's claim scrubber integrates seamlessly with existing systems to provide real-time validation and error detection. It offers payer-specific edits and detailed analytics to improve claim accuracy.
PracticeSuite's claim scrubber automates error detection to ensure claims comply with all payer rules and regulations. Integration with EHR and PMS systems creates a seamless workflow for staff. This allows teams to focus on revenue optimization rather than repetitive corrections.
Telcor's RCM claim scrubber provides automated validation and compliance checks across all claims. Real-time feedback allows staff to quickly correct issues before submission.
NikoHealth's claim scrubber features automated error detection and payer-specific edits. It integrates with existing systems to streamline billing and improve accuracy. This helps practices submit cleaner claims faster and reduce administrative workload.
Shavara's customizable claim scrubber is part of its broader revenue cycle management suite. It identifies and resolves errors before submission, reducing denials and protecting revenue.
Claim scrubber software offers several advantages that streamline workflows, reduce errors, and improve revenue cycle performance.
Claim scrubber software automatically flags errors before submission, significantly reducing the need for resubmissions. This helps practices avoid delays in reimbursement and ensures that claims are paid faster, minimizing revenue loss caused by denied claims.
Automation accelerates claim processing and approval, allowing healthcare organizations to receive payments more quickly while ensuring regulatory adherence. By reducing bottlenecks, it also improves the overall cash flow and stability of the practice.
The software ensures adherence to payer rules and regulatory requirements. Regular updates to coding standards reduce the risk of audit penalties, keeping claims accurate and compliant. It also provides peace of mind for administrators managing complex revenue cycles.
Staff are freed from repetitive manual checks, giving them more time to focus on high-value tasks. This boosts operational efficiency while supporting better management of complex claims.
Dashboards and analytics track claim accuracy, denials, and performance trends. Administrators can identify recurring errors, monitor workflow efficiency, and make data-driven decisions to optimize revenue cycle management.
These features work together to streamline claim processing, reduce errors, and support more efficient revenue cycle management.
The software identifies missing or incorrect codes and modifiers. By catching these errors before claims are submitted, it reduces denials and rework. Over time, this feature can dramatically improve overall billing accuracy.
Built-in logic ensures claims meet specific payer requirements. This keeps claims compliant with ever-changing regulations and reduces the risk of audit penalties.
Duplicate claims are automatically flagged and prevented from submission. This safeguards revenue and avoids delays caused by rejected claims, allowing billing staff to focus on resolving complex cases rather than correcting repetitive errors.
Seamless integration eliminates redundant data entry and improves workflow efficiency. Staff can access the same data across clinical and administrative teams, reducing errors and saving time.
Dashboards and reports provide insights into denials, errors, and revenue opportunities. Administrators can identify trends, spot recurring issues, and implement targeted improvements. These analytics help optimize claim performance across the organization.
Staff receive real-time notifications about potential issues in claims. Immediate alerts allow teams to address problems quickly, improving first-pass acceptance and enabling corrective action as needed. This proactive approach reduces downstream rework and strengthens overall revenue cycle management.
Choosing the right claim scrubber software requires careful evaluation of several factors. Beyond basic functionality, it’s important to ensure the tool fits your organization’s workflow, scales with your needs, and provides strong support and compliance safeguards.
The software must work seamlessly with EHRs, billing systems, and practice management platforms. Proper integration eliminates duplicate data entry and reduces errors. This ensures a smoother workflow across both clinical and administrative teams.
A good solution should grow with your organization’s size and needs. Whether you’re adding new locations, specialties, or staff, scalable software ensures long-term adaptability.
Intuitive interfaces minimize training time and improve adoption. Staff can navigate the system efficiently, reducing mistakes and boosting productivity.
Reliable vendor support helps resolve issues quickly and reduces costly downtime. Comprehensive support, including training, troubleshooting, and updates, ensures your team can make the most of the software.
HIPAA-compliant software with robust data protection safeguards patient information and ensures adherence to health insurance portability regulations. Built-in encryption, access controls, and audit trails reduce the risk of breaches while supporting ongoing regulatory compliance.
Consider not just licensing fees but also implementation, training, and ongoing maintenance costs. Evaluating all aspects of cost upfront prevents surprises. It also helps ensure a strong return on investment over time.
Claim scrubber software has become an essential tool for healthcare organizations seeking to reduce denials, improve cash flow, and ensure compliance in processing medical claims. By automating claim validation, applying payer rules, and providing actionable insights, these platforms streamline revenue cycle management and free staff to focus on higher-value tasks.
Among the top solutions, Aptarro RevCycle Engine stands out for its AI-powered error detection, comprehensive compliance checks, and seamless integration with EHRs and billing systems. Explore how Aptarro can optimize your claims.
Request a demo today to experience its impact firsthand.