Resources
Guides on billing and revenue cycle management.
Practical references for keeping claims clean and denials down. More guides are on the way — reach out directly if you have a specific question in the meantime.
Denial Prevention Checklist
Work through each step, from scheduling to post-payment follow-up, to catch the issues that cause most avoidable denials before a claim goes out the door.
- Verify patient demographics, insurance eligibility, and benefits before the appointment
- Confirm referral and prior authorization requirements and obtain approvals before services
- Verify provider, facility, and payer network requirements
- Confirm medical necessity and required clinical documentation
- Ensure accurate charge capture and complete documentation
- Verify ICD-10, CPT/HCPCS codes, modifiers, units, and place of service
- Review claims for errors and payer-specific requirements before submission
- Submit clean claims within payer timely-filing limits
- Monitor claim acceptance, rejections, and payment status and correct issues promptly
- Identify, analyze, and appeal denials promptly based on root cause
- Track denial trends and implement corrective actions to prevent recurring denials
- Keep billing and coding teams informed on coding, payer, and regulatory changes