Pre-Submission Claim Checklist
A pre-submission checklist the billing team works for every claim: eligibility, authorization status, CPT and ICD-10 validation, documentation, and clean-claim elements, checked before the claim goes out.
Free. Updated August 2026.
What's on the form
1
Eligibility Verification
2
Authorization Status
3
Coding Validation (CPT + ICD-10)
4
Documentation Requirements
5
Clean Claim Elements
Who fills it in
The biller, per claim, before submission. Each item is a known denial cause; checking it before the claim leaves the building costs seconds, while working the same issue as a denial costs weeks. Note exceptions in the margin.
Before you hand it out
The last page of the PDF is a note to the practice, with a reminder to remove it before the packet is copied or handed out. Review the form with your clinical leadership and counsel first, and adapt anything that does not match how your practice runs.