Checklist Gets You Clean Claims

Use checklist to boost accuracy and payup.

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)?

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