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)?