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Denial prevention checklist
A one-page checklist for the front desk and billing team. Print it, keep it by the workstation, and run through it before claims go out. Most denials trace back to a handful of steps that are easy to miss on a busy day.
What's on it
Before the visit
Eligibility for the actual date of service, network status, coordination of benefits, referrals, and prior authorization details.
During and after the visit
Documentation that supports medical necessity, and services that match what was authorized.
Before submitting the claim
Billing/rendering NPIs, taxonomy, diagnosis specificity and pointers, modifiers, bundling edits, and corrected-claim handling.
Timely filing and follow-up
Filing deadlines, proof of timely filing, clearinghouse rejections, and reading CARC and RARC codes together.
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