Checklist Gets You Clean Claims

Posted on 20. Apr, 2009 by Editor in Toolkit

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?

Bad news: Even clean claims get denied. Good news: Jillian Harrington shows you how to appeal MUEs.

• 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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Tags: checklist, clean claims, front desk, insurance eligibility verification