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Revenue Cycle
A pre-claim review checklist for revenue cycle teams
The documents and checks that most often cause problems, and how to verify them before a claim moves forward.
Trowel Team
August 9, 2026 · 7 min read
Pre-claim review is one of the most effective ways to reduce rework in the revenue cycle. Here are the checks revenue cycle teams tell us matter most.
Patient and coverage
- Demographics match across registration and clinical documents.
- Eligibility verified for the date of service.
- Member ID and plan details are complete.
Authorization
- Authorization is present when required.
- Authorized services and dates cover what was performed.
Clinical documentation
- Required notes and reports are attached.
- Documented procedures are consistent with requested codes.
- Signatures and dates are present.
Putting it into practice
Start by writing these checks down for your most common claim types. Then decide which ones can be checked automatically and which need a specialist to review.