Before you submit

Check a claim against the most common denial and underpayment causes before it goes out.

Prototype. Use synthetic data only.

Claim & documents

InsurerPlan typeDate of service

Denial or payment notice

Denial letter, EOB, payment notice

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Billing record

Original claim and 835 remittance

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Authorization

Approval letter, reference numbers, call logs

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Clinical record

Clinic notes, operative report, imaging reports

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Payer documents

Medical policy, provider contract, rate schedule

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Readable text files use explicit fields and literal evidence matches. PDF and DOCX require a text copy. Missing or ambiguous facts always need review.

Clinician setup checklist

Documented failed treatments

Note matches imaging

Every planned procedure listed on authorization request

Authorization letter saved with dates

New authorization if scope changes

Operative note completed same day

Evidence flags only; no suggested wording or codes. Nothing is sent to an insurer. Practice-specific checklist and legal applicability require qualified review.