Top 30 Best Medical Claims Scrubbing Software Solutions
A crucial phase in revenue cycle management is medical claims scrubbing, which makes sure that claims are clear, compliant, and prepared for submission to payers. Scrubbing tools that work decrease denials, speed up reimbursements, and allow personnel to concentrate on patient care. This article profiles the Top 30 medical claims scrubbing Software Solutions covering deep clinical edits, AI-powered flagging, integration with EHR/PM systems, and enterprise workflows. Each entry includes key features, pros/cons, pricing insights, expert commentary, and a demo link to help you navigate solutions tailored to your organization’s needs.
Top 30 Best Medical Claims Scrubbing Software Solutions
1. claimWizard Pro
A robust claim scrubber that applies crosswalk edits and national guidelines to ensure CPT-ICD pairing, reduce denials, and maximize reimbursements.
Key Features – ICD‑CPT cross-walk, NCD/LCD compliance, NCCI edits, RVU optimization, real-time CMS updates
Pros and Cons – Pros: Highly accurate coding, quick ROI. Cons: Interface is dated and lacks advanced integrations.
Detailed Pricing – Pro version available at low per‑user cost; Lite edition is free for CMS‑1500 scrubbing.
Expert Commentary – “claimWizard Pro eliminates mismatches and optimizes RVUs—ideal for precise billing.” – Sarah Johnson, Coding Operations Manager
Demo Video – Watch claimWizard Pro demo on YouTube
2. AdvancedMD ClaimInspector
A claims scrubbing engine integrated into the AdvancedMD billing system, offering 95%+ first-pass clean claim rates.
Key Features – 119M+ edits from Optum database, customizable rules, batch scrubbing, denial prevention
Pros and Cons – Pros: Seamlessly integrated PM/EHR, high clean-claim performance. Cons: Requires AdvancedMD billing package.
Detailed Pricing – Included in AdvancedMD billing plans (~$250–$700/provider/month).
Expert Commentary – “We saw fewer rejections and faster reimbursements thanks to ClaimInspector accuracy.” – Linda Parker, RCM Director
Demo Video – Watch AdvancedMD ClaimInspector demo on YouTube
3. Auxee AI Claims Scrubber
An AI-based scrubber catching coding, provider info, and signature issues—reducing denial rates by 45% in early use.
Key Features – AI-driven edits, instantaneous notifications, workflow integration with PM systems
Pros and Cons – Pros: Fast setup, reduced scrubbing time. Cons: Still maturing payer rule coverage.
Detailed Pricing – Free trial; pricing based on claim volume.
Expert Commentary – “Auxee felt like a ‘magic’ upgrade, reducing dental claim denials by 7%.” – Chief Compliance Officer, Midwest Dental Group
Demo Video – Watch Auxee AI demo on YouTube
4. ClaimStaker (Alpha II / eProvider Solutions)
Enterprise-grade clinical scrubber embedding clinical edits, E&M acuity checks, and payer-grade logic into workflows.
Key Features – LCD/NCD and proprietary medical necessity edits, compliance reporting, customizable rule wizard
Pros and Cons – Pros: Deep clinical logic; payer-grade accuracy. Cons: Requires configuration by experts.
Detailed Pricing – Custom licensing; ROI calculators available.
Expert Commentary – “ClaimStaker’s E&M acuity and compliance checks make for top-tier scrubbing.” – Todd Frischknecht, CEO, EasyCoder integration partner
Demo Video – Watch ClaimStaker demo on YouTube
5. 1st Providers Choice Claim Scrubber
CMS‑1500 and electronic claim scrubber built into front-end EMS workflows, with 81M+ edit rules and payer parity.
Key Features – Front-load format and code checks, Medicaid/Medicare/LCD/NCCI edits, real-time alerts
Pros and Cons – Pros: Avoids payer denials by using same rules upfront. Cons: Limited institutional claim support.
Detailed Pricing – Included in their PM software; contact vendor for bundle pricing.
Expert Commentary – “Their claims align with payer tools—so you rarely get errors past submission.” – Facility Billing Manager
Demo Video – Watch 1st Providers Choice demo on YouTube
6. AdvancedMD Billing Suite
Beyond ClaimInspector, the platform includes analytics, patient statements, and reporting modules in one RCM suite.
Key Features – Scrubbing, denial workflow, reporting, statement cycle integration
Pros and Cons – Pros: Full RCM integration; mobile dashboards. Cons: Higher per-provider pricing.
Detailed Pricing – USD 250–700/provider/month.
Expert Commentary – “This combines scrubbing with end-to-end RCM workflows—powerful and unified.” – RCM Manager, Small Specialty Group
Demo Video – Watch AdvancedMD RCM suite demo on YouTube
7. PracticeSuite Claim Management
Cloud-based solution offering automated claim edits, eligibility checks, and customizable templates for mid-size practices.
Key Features – Auto-edit logic, EHR integration, real-time eligibility verification, billing alerts
Pros and Cons – Pros: Affordable and versatile. Cons: Some advanced claims features require upgrades.
Detailed Pricing – Available on request; priced for mid-size practices.
Expert Commentary – “PracticeSuite brings customizable scrubbing and real-time checks at a reasonable cost.” – Billing Director, Community Clinic
Demo Video – Watch PracticeSuite demo on YouTube
8. CollaborateMD Claim Scrubber
A cloud-based billing package with built-in scrubbing logic and mobile dashboards for small to mid-size clinics.
Key Features – Real-time scrubbing, mobile claim submission, analytics dashboards, EHR links
Pros and Cons – Pros: Mobile-friendly; easy to use. Cons: Not as deep as enterprise engines.
Detailed Pricing – Contact vendor; pricing tiers available.
Expert Commentary – “CollaborateMD helps our billing team scrub and submit claims while away from desktop.” – Orlando Clinic Administrator
Demo Video – Watch CollaborateMD demo on YouTube
9. Waystar Claims Management Automation
AI-driven platform automating denial prevention, appeals, and claim status monitoring; integrates easily with existing PM/EHR.
Key Features – Predictive denial alerts, intelligent worklists, auto-app appeals, benchmarking analytics
Pros and Cons – Pros: Strong automation; fast ROI. Cons: Requires integration and setup.
Detailed Pricing – Basic: USD 199/provider/month; Advanced: USD 299/provider/month.
Expert Commentary – “Waystar speeds up claims and intelligently finds appeal opportunities.” – RCM Executive, Hospital Group
Demo Video – Watch Waystar demo on YouTube
10. EZClaim
Budget-friendly scrubber ideal for small practices, offering automated edits, ERA processing, and patient statements.
Key Features – Claim scrubbing, remittance processing, billing alerts, eligibility checks
Pros and Cons – Pros: Affordable; easy setup. Cons: Basic analytics; limited payer logic in lower tiers.
Detailed Pricing – Basic: USD 99/provider/mo; Advanced: USD 149; Premium: USD 199.
Expert Commentary – “EZClaim gives small practices scrubbing power without risk or complication.” – Practice Manager, Pediatric Clinic
Demo Video – Watch EZClaim demo on YouTube
11. Aptarro RevCycle Engine
A robust, payer-grade claims editing and revenue integrity platform with over four decades of rules for compliance and denial prevention.
Key Features – 40+ years of logic, EHR/PM integration, automated correction, compliance reporting
Pros and Cons – Pros: Deep clinical/payer logic; reduces denials. Cons: Requires onboarding; geared toward mid-large systems.
Detailed Pricing – SaaS licensing; contact vendor for quotes.
Expert Commentary – “Aptarro offers payor-level accuracy with continuous edits and deep rule coverage.” – Dr. Hema Patel, Revenue Integrity Specialist
Demo Video – Watch Aptarro RevCycle Engine demo on YouTube
12. TriZetto QNXT Claims Scrubber
A payer-grade claims engine that ensures compliant claims formatting and edits for large healthcare organizations.
Key Features – Automated processing, eligibility checks, contract-model validation, compliance engine
Pros and Cons – Pros: Scalable for large provider networks. Cons: Less suited for small practices.
Detailed Pricing – Custom enterprise model.
Expert Commentary – “TriZetto is best-of-breed for high-volume RCM teams needing payer-level edits.” – Jeff Simmons, Health Plan Billing Director
Demo Video – Watch TriZetto QNXT demo on YouTube
13. McKesson ClaimsXten
Clinical criteria-based claim validation engine combining InterQual logic to ensure evidence-based medical necessity scrubbing.
Key Features – InterQual-based reviews, custom rule creation, denial risk scoring
Pros and Cons – Pros: Advanced medical necessity checks. Cons: Usually part of broader clinical suite.
Detailed Pricing – Payer/provider pricing on request.
Expert Commentary – “ClaimsXten layers clinical rigor into claims—it’s more than syntax scrubbing.” – Dr. Linda Matthews, Clinical Coding Lead
Demo Video – Watch McKesson ClaimsXten demo on YouTube
14. ClearClaim (HealthEdge Source Editing)
Integrates clinical and administrative rules for claim optimization in value-based care and payer environments.
Key Features – Rule editor, claims auditing, regulatory compliance engine, analytics
Pros and Cons – Pros: Highly configurable; suited for value-based payment. Cons: Intended for payer integration.
Detailed Pricing – SaaS licensing; contact vendor.
Expert Commentary – “ClearClaim supports payers and provider groups with deep administrative logic and adaptability.” – Sarah Wells, Value-Based Contract Manager
Demo Video – Watch ClearClaim demo on YouTube
15. eClinicalWorks RCM Scrubber
A unified RCM module with built-in claim scrubbing, eligibility checks, and analytics—all integrated with eClinicalWorks EHR.
Key Features – Integrated scrubbing, real‑time eligibility, denial insights, analytics dashboards
Pros and Cons – Pros: One platform; strong EHR synergy. Cons: Less depth compared to dedicated scrubbers.
Detailed Pricing – Request custom quote.
Expert Commentary – “eClinicalWorks brings claims cleaning into everyday practice workflows—simple and effective.” – Dr. Simon Ruiz, Ambulatory RCM Lead
Demo Video – Watch eClinicalWorks RCM scrubber demo on YouTube
16. NextGen Claims Scrubbing Engine
A NextGen RCM module with predictive claim editing, payer rule libraries, and denial prevention alerts.
Key Features – AI-driven edits, denial insights, eligibility checker, integration with PM/EHR
Pros and Cons – Pros: Automated, proactive scrubbing. Cons: Tighter integration required.
Detailed Pricing – Enterprise tiers; vendor contact needed.
Expert Commentary – “NextGen scrubs claims with intelligence and flags issues before they become denials.” – Amy Grant, Billing Systems Specialist
Demo Video – Watch NextGen claims scrubber demo on YouTube
17. Kareo Claims Scrubber
Designed for small to mid-size practices, offering real-time claim scrubbing and eligibility verification in a cloud platform.
Key Features – Real-time scrubbing, patient eligibility, denial analytics, integrated dashboard
Pros and Cons – Pros: Affordable and intuitive; fast deployment. Cons: Not as deep as enterprise systems.
Detailed Pricing – Contact vendor; small-practice pricing.
Expert Commentary – “Kareo gives small groups the power of real-time edits without complexity.” – Practice Manager, Family Clinic
Demo Video – Watch Kareo claims scrubber demo on YouTube
18. DrChrono Claim Scrubbing
Built into its EHR/PM, DrChrono validates codes, flags mismatches, and prevents submission errors in real time.
Key Features – Integrated scrubber, eligibility check, denial tracking, mobile-friendly
Pros and Cons – Pros: Convenient and embedded; mobile-ready. Cons: Basic payer logic.
Detailed Pricing – Enterprise tiers; vendor contact required.
Expert Commentary – “DrChrono’s scrubber is simple yet effective—great for practices on the go.” – Dr. Helen Zhao, Small Practice Owner
Demo Video – Watch DrChrono scrubber demo on YouTube
19. CareCloud Spend & RCM Scrubber
Cloud RCM with scrubbing, denials prevention, and spend analytics built alongside its PM/EHR suite.
Key Features – Automated rule edits, denial alerts, financial analytics, integrated workflows
Pros and Cons – Pros: Alignment with CareCloud suite; good RCM visibility. Cons: Scrubber is entry-level compared to specialty tools.
Detailed Pricing – Pricing on quote; often part of RCM package.
Expert Commentary – “CareCloud integrates scrubbing within a full-service billing workflow—simple and effective.” – CFO Advisor, Ambulatory Network
Demo Video – Watch CareCloud scrubber demo on YouTube
20. Pellucid Healthcare PMS Scrubber
Ideal for mid-size practices, this cloud PMS includes claim scrubber and eligibility checks to support accurate billing.
Key Features – Claim validation, patient eligibility, batch scrubbing, denial reporting
Pros and Cons – Pros: Good balance of cost and features. Cons: Vendor is lesser-known—support may vary.
Detailed Pricing – Tiered monthly pricing; vendor inquiry required.
Expert Commentary – “Pellucid gives mid-size groups punchy RCM tools without enterprise complexity.” – RCM Analyst, Regional Practice
Demo Video – Watch Pellucid scrubber demo on YouTube
21. PointClickCare ClaimsXpert
Designed for long-term and post-acute care providers, offering automated claim edits and denial management tailored to LTPAC settings.
Key Features – LTPAC-specific rules, batch scrubbing, denial alerts, integration with EHR workflows
Pros and Cons – Pros: Specialized for post-acute care; seamless EHR integration. Cons: May not fit acute/hospital needs.
Detailed Pricing – Tiered subscription; contact vendor for pricing.
Expert Commentary – “ClaimsXpert brings focused scrubbing for skilled nursing—saving time and improving accuracy.” – Suzanne Lewis, LTPAC Billing Manager
Demo Video – Watch PointClickCare ClaimsXpert demo on YouTube
22. Bettererz Claim Scrubber
A lightweight cloud scrubber for chiropractors and small specialty practices that flags basic coding errors.
Key Features – Specialty-specific rules, real-time scrubbing, simple UI, eligibility check
Pros and Cons – Pros: Easy setup; affordable; tailored for chiropractors. Cons: Limited beyond chiropractic billing.
Detailed Pricing – Plans from USD 49/provider/month.
Expert Commentary – “Bettererz delivers focused scrubbing for small specialty clinicians—simple and practical.” – Dr. Matt Sanders, Chiropractic Practice Owner
Demo Video – Watch Bettererz scrubber demo on YouTube
23. Suncoast ClaimLogic
Claims processing and scrubbing suite tailored for billing services, including practice workflows and payer rulesets.
Key Features – Coding rule engine, customizable pipelines, role-based workflows, reporting
Pros and Cons – Pros: Built for billing teams; robust pipeline control. Cons: Requires setup and maintenance.
Detailed Pricing – Custom quotes based on claim volume.
Expert Commentary – “ClaimLogic gives billing services transparency and control over scrubbed claims.” – Alice Johnson, Billing Service Director
Demo Video – Watch Suncoast ClaimLogic demo on YouTube
24. ZirMed Claims & Remits (Waystar)
Part of the Waystar platform, this tool checks claims before submission, consolidates remittance information, and automates workflows.
Key Features – Real-time claim checks, remittance insights, analytics, denial tracking
Pros and Cons – Pros: Unified scrubbing and remittance processing. Cons: Tie-in with Waystar migration required.
Detailed Pricing – Basic from USD 199/provider/month; Advanced at USD 299/month.
Expert Commentary – “ZirMed ensures both scrubbing and remits are tracked in one place—no more disconnected systems.” – RCM Operations Lead
Demo Video – Watch ZirMed scrubber demo on YouTube
25. SSI Group Claim Management
A comprehensive scrubbing and denial prevention suite designed for billing companies and large provider groups.
Key Features – Multi-payer edits, rule-based workflows, appeals management, analytics
Pros and Cons – Pros: Deep editing for commercial payers; customizable. Cons: Best suited to larger group models.
Detailed Pricing – Custom; based on organization size.
Expert Commentary – “SSI Group gives complex organizations the editing and rules they need at scale.” – RCM Systems Analyst
Demo Video – Watch SSI Group claim module demo on YouTube
26. ZeOmega Infinit RxClaims
A claims editing engine focused on clinical correctness and payer compliance, used by IPAs and provider networks.
Key Features – Prior authorization checks, error rule editor, payer validation, batch submission
Pros and Cons – Pros: Advanced clinical logic; good for physician networks. Cons: Requires integration and support.
Detailed Pricing – Contact for enterprise pricing.
Expert Commentary – “Infinit RxClaims aligns clinical and payer rules seamlessly—great for physician-led networks.” – Network RCM Lead
Demo Video – Watch ZeOmega Infinit demo on YouTube
27. Medikanz Claims Scrubber
A European-focused claims scrubbing engine covering ICD-10 variations and national payer rulesets.
Key Features – Regional code rulesets, batch scrubbing, denial alerts, compliance reporting
Pros and Cons – Pros: Tailored for European healthcare systems. Cons: Limited use outside Europe.
Detailed Pricing – Annual licensing; request regional quote.
Expert Commentary – “Medikanz speaks the local language—literally and in coding rules.” – EU Billing Manager
Demo Video – Watch Medikanz scrubbing demo on YouTube
28. FormFast Claims Gateway
Combines form automation with claim scrubbing to ensure clean submissions from form entry.
Key Features – Form-based claim validation, pre-submission checks, real-time alerts
Pros and Cons – Pros: Front-end catch errors early; smart form logic. Cons: Less suited for post-submission audits.
Detailed Pricing – Contact vendor.
Expert Commentary – “FormFast prevents bad data from ever hitting the billing pipeline—ideal for specialty clinics.” – Medical Informatics Specialist
Demo Video – Watch FormFast claim demo on YouTube
29. ChartLogic Claims Module
Built into ChartLogic EHR, this module applies coding and eligibility scrubbing before claims generation.
Key Features – Embedded scrubber, real-time eligibility, dashboard alerts, mobile support
Pros and Cons – Pros: Seamless within ChartLogic workflows. Cons: Limited depth compared to specialized scrubbers.
Detailed Pricing – Included with ChartLogic EHR; ask vendor.
Expert Commentary – “ChartLogic’s claims tool works quietly in the background—no separate system needed.” – Clinic RCM Lead
Demo Video – Watch ChartLogic claims module demo on YouTube
30. Symbion ASP Claims Suite
ASP-hosted claims scrubbing and denial module for mid-size hospitals and health systems.
Key Features – Web-based scrubbing, denial management, analytics, payor rule updates
Pros and Cons – Pros: Mid-market fit; hosted solution. Cons: Limited tailoring options.
Detailed Pricing – Subscription; contact vendor.
Expert Commentary – “Symbion offers a hosted route to clean claim workflows—good for mid-size hospitals.” – CIO, Regional Health System
Demo Video – Watch Symbion claims suite demo on YouTube
Conclusion
Scrubbing medical claims effectively is crucial to reducing denials and speeding up payment. The aforementioned top 30 tools cover a wide range of practice environments, from small clinics to extensive hospital systems, from payor modifications in Europe to U.S.-focused solutions. Platforms should be assessed according to their RCM volume, specialization emphasis, rule depth, and simplicity of integration. Prioritize those that fit your clinical workflows and payer mix and always test with demos to make sure they work and provide a return on investment.