The Checklist For Clean Claims

Has your office ever received a claim that was denied due to insufficient initial reporting? If not, consider yourself in the minority, because insufficient initial reporting is a leading cause of claim denials. What to do? Help your office get it right the first time by printing out this checklist as a guide to clean claims. Post it wherever claims are processed, so you can check the list before sending every claim to ensure accuracy:

Clean Claim Checklist

So your claim’s ready for submission? Have you:

  • Made sure the policy number and ID number are accurate?
  • Obtained insurance eligibility verification?
  • Verified other patient information (proper name, birth date, address, etc.)?
  • Confirmed the information the provider gave you for posting charged entries?
  • Checked that Current Procedural Terminology (CPT) and ICD-9 (diagnosis) codes are up-to-date and as specific as possible?
  • Made sure that you have the referral authorization number on the form, if applicable?
  • Made sure that you included the referring doctor’s UPIN or HPI, if required?

Additional Resources on Claims

Have questions? I’m here to help.