Do’s and Don’ts for Filing Clean Claims

Expect insurance companies to begin scrutinizing more closely than ever the claims you submit. Here are some tips for filing clean claims:

Tips for filing electronic claims:

DO …

  • Verify, file, and keep all transmission reports.
  • Track clearinghouse claims to ensure successful transmission.
  • Ensure your computer software is consistent with the clean claims rules.
  • Verify that your software correctly prints the CMS-1500 claim form.
  • Call your software vendor, if needed, to address the above two items.

 

Tips for filing paper claims:

DO …

  • Use only original claim forms (printed in red drop-out ink).
  • Avoid folding claims, if possible.
  • Resist using terms such as "refiled claim," "second request," or "corrected claim."
  • Avoid handwritten claims.
  • Use all UPPERCASE letters.
  • Stay inside the lines of each block.
  • Ensure claims are printed darkly.

 

DON'T …

  • Use any punctuation or decimals.
  • Send unnecessary attachments.
  • Use staples or paperclips.
  • Attach "post-it" notes.
  • Mark up the claim with highlighters.
  • Use circles or additional markings.
  • Attach labels or stickers.
  • Add notes or instructional assistance.

Don't give insurance companies an excuse to reject your claims.

 

TMA Practice E-tips main page


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