The Checklist For Clean Claims

Written by Reed Tinsley, CPA | March 27, 2009

Clean Claim Checklist: Ensure Accurate Submissions Every Time

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

To ensure your medical practice minimizes claim denials and operates smoothly, integrate our expert guidance. Contact us at REED TINSLEY, CPA today for personalized CPA + medical practice management consulting solutions.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.

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