Medical Practice Management
Mar 27

This Checklist Gets You 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:

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)?

About Reed Tinsley, CPA

As a top advisor to physicians, I help increase practice profits by delivering hands-on, expert medical accounting/tax support, practice counsel, and revenue-building strategies. Read more →