Ibex practice resources · Reviewed October 22, 2026 · Ibex editorial team
Match the service and setting
Review what was performed, where and who supplied each component. Ask for clarification rather than assuming details.
Check supporting information
Confirm that the available indication and authorization details support the proposed submission where required.
Review applicable edits
Check procedure relationships and documentation before considering a modifier. Modifiers should not simply be used to force a claim through.
Track records requests
Assign an owner to payer documentation requests and record the relevant deadline.
Put the checklist into practice.
Use one recent workflow issue as a starting point. Identify what information was available, where the handoff stalled and which team member can answer the next question. This keeps the review focused on a specific process rather than a general assumption about billing performance.
Record the question, the owner and the next action. At a later review, check whether the change addressed the same issue. Keep reporting definitions consistent so the comparison remains useful.
Questions for your next team review
- Which step needed information that was not available?
- Was the applicable payer requirement checked for the actual service?
- Who owned the response and its deadline?
- What should change before the next similar encounter?
For California practices, the relevant payer route may include fee-for-service Medicare, Medi-Cal or a managed care or commercial product. Confirm the actual product and requirements for the service.