Staff Series – R4 M2: Using Technology to Reduce Rework
RCM FOUNDATION SERIES · ROUND 4
Module 2 of 3

Using Technology to Reduce Rework

Round 4 — Module 2 · Letting your systems catch problems before they multiply
Your name will appear on your certificate when you complete this round.
Round 4 Progress
1
Internal Controls
2
Technology & Rework
3
Payment Model Changes

The Systems Already Do Some of the Work

The EMR, the clearinghouse, and the billing system all have built-in checks meant to catch errors before a claim ever goes out. Ignoring or clicking past these checks doesn't make them go away — it just moves the problem downstream, to a denial that takes far longer to fix.

Where These Checks Show Up

Claim Scrubbers

Automated edits that flag missing modifiers, mismatched codes, or incomplete information before a claim submits. A scrubber warning is a chance to fix something in seconds instead of weeks.

Eligibility Verification Tools

Real-time checks that confirm active coverage before or at the visit. Skipping this step to save a minute at check-in can cost far more time later, in a denial.

Task Queues and Work Lists

Built-in reminders showing what needs follow-up and when. These exist specifically so nothing has to be tracked from memory.

Why This Matters

A system warning caught today is minutes of work. The same issue caught after a denial is often an hour or more — researching, correcting, and resubmitting a claim that could have gone out clean the first time.

Where Technology Gets Underused

Common patterns to watch for: dismissing scrubber warnings without reading them, skipping eligibility checks when the schedule is full, and letting work-list items pile up unaddressed because there isn't a set time each day to work through them.

Check Your Understanding

1. What is the purpose of a claim scrubber warning?
Correct. Scrubber warnings exist to catch issues while they're still quick to fix.
Not quite. A scrubber warning is meant to catch an error before submission, saving time later.
2. What happens when an issue caught by a system warning gets ignored instead of fixed?
Correct. Ignored warnings tend to become denials, which take far longer to resolve.
Not quite. An ignored warning typically resurfaces later as a denial.
3. What are task queues and work lists designed to do?
Correct. These lists exist so nothing depends on someone remembering it.
Not quite. Task queues are built so follow-up doesn't depend on memory.

Nice work — continue to Module 3.

Continue to Module 3