Claim Submission Services

Claim submission services

Claim submission services get clean claims out of your system and accepted by the payer.

See where claims are getting stuck. No patient data needed.

We scrub each claim against clearinghouse and payer edits, submit electronically as 837P or 837I, work every rejection before the next batch goes out, and track each claim to payer acceptance so nothing sits in a batch nobody checks.

This is part of getting the claim out clean. Buy it on its own or pair it with our other billing services, stage by stage.

Last reviewed October 21, 2026 by the Remitwright billing team. Editorial policy

What claim submission covers

Claim batches created and released from your PM system, electronic through your clearinghouse, paper only where a payer still requires it

Scrubber edits worked before release: NPI and taxonomy, subscriber and patient data, code validity, modifier logic, place of service, diagnosis pointers, filing dates

Payer-specific edits maintained for the payers that reject on their own rules

Clearinghouse rejections (the 277CA and front-end reports) worked before the next batch goes out, not left in a queue

Payer acknowledgement tracked, because a claim is not done until the payer has accepted it

Secondary and tertiary claims submitted with the primary remittance attached, or crossed over automatically where the payer supports it

Corrected claims (frequency code 7) and voids (frequency code 8) submitted correctly so they replace rather than duplicate

Timely filing tracked by payer, with claims at risk flagged well before the limit

What goes wrong when claim submission is skipped

The batch that never left

Claims were created on Friday and the batch was never released. Nobody looked until the following Friday. A week of cash is now a week late, and three Medicaid claims crossed a filing deadline sitting in the queue.

The rejection nobody read

The clearinghouse rejected fourteen claims for an invalid subscriber ID. The report went to an inbox nobody checks. The claims do not exist at the payer, so there is no denial to appeal, and a month later someone wonders why that payer stopped paying.

The corrected claim that became a duplicate

A claim is resubmitted as a new claim instead of a frequency 7 replacement. The payer denies it as a duplicate (CO-18). The original is still wrong. Now there are two problems.

How we run claim submission

Scrub

Every claim passes PM edits, clearinghouse edits and our payer-specific list before release. Fails are fixed, not bypassed.

Release

A batch is released once every claim in it has passed the scrub. Paper claims, attachments and payer-portal submissions go on the same release log.

Acknowledge

The 277CA and payer acknowledgements are reconciled against the batch. Every claim gets an accepted status or a rejection task.

Rework

Rejections are fixed and resubmitted before new claims go out. Repeated rejection reasons become new scrubber rules.

Track

Claims are followed to the payer's adjudication. No response inside the payer's normal window triggers A/R follow-up.

Worked example: the Medicaid MCO edit

A hypothetical pediatric practice has a steady share of claims to one Medicaid managed care plan rejected for a missing rendering provider taxonomy, a rule that payer enforces and others do not. The biller adds a payer-specific edit in the PM system so claims to that MCO cannot be released without the taxonomy. Rejections for that reason stop. The practice had been fixing them by hand, one at a time, for a year.

Questions about claim submission

What is a clean claim?

A claim that is accepted by the payer and adjudicated on first submission with no rejection, no pend for information and no denial for a correctable error. First-pass resolution rate is the share of claims that meet that bar, and it is the clearest measure of front-end billing quality.

Do you submit paper claims?

Only where a payer or situation requires it: some workers' compensation and auto carriers, certain attachments, a few small plans. Everything else goes electronically through your clearinghouse.

Do we need to change clearinghouses?

No. We work in the one you have. If yours is causing problems we will say so and explain the options, but switching is your call.

How do you handle secondary claims?

Where the primary payer crosses over automatically, as Medicare does to most supplemental plans, we confirm the crossover happened. Where it does not, we submit the secondary with the primary remittance data once the primary payment is posted.

What is the difference between a rejection and a denial?

A rejection happens before adjudication: the clearinghouse or payer front end refuses the claim for a data problem, and it never enters the payer's system. A denial is an adjudicated claim the payer has decided not to pay. Rejections are fixed and resubmitted; denials are worked and appealed.

When are rejections fixed?

Before anything new goes out. A rejected claim is invisible to the payer, so every day it sits is a day of filing time lost.

Can claim submission be outsourced on its own?

It can, though it rarely stays alone. A biller who only submits claims sees rejections and denials come back and has nowhere to send them. If you want submission only, the scope says who works the 277CA rejections and who works the denials, so nothing falls between two desks.