IE

Implant Review Essentials

High-Dollar Claim Review · Nurse Education

Assessment Tool · Objective 3

Investigational-Implant Review Checklist

Work this checklist right here on screen — tick each step as you complete it and your score updates as you go. Your work is saved in this browser, so you can come back to it. Mastery is at least 80% of the steps completed correctly.

0/29 · 0%

Goal 80%

Before you begin

Enter your name and work email so your instructor can record the checklist you send in.

Claim identification

  1. 1

    Verify the implant or device

    Confirm exactly what was implanted before researching any policy.

    0/4
  2. 2

    Locate the current medical policy

    Find the governing policy and confirm the version is current.

    0/3
  3. 3

    Verify the FDA status

    Confirm the approval pathway and the approved indication.

    0/3
  4. 4

    Apply the policy to the claim facts

    Map the documented circumstances against the policy language.

    0/4
  5. 5

    Document your findings

    Write a note that stands on its own — no follow-up needed.

    0/4
  6. 6

    Take the appropriate next action

    Route the claim forward correctly.

    0/4
  7. 7

    Check yourself against the common errors

    Rule out the three errors that most often undo a review.

    0/3
  8. 8

    Final review for completeness

    Confirm the review stands on its own before sign-off.

    0/4

Determination

Mastery score

Steps completed

0

Total required steps

29

Percent complete

0%

Mastery goal: ≥ 80% of the required steps completed correctly. If below 80%, review the feedback and repeat a practice case before reassessment.

Tick at least one step first.

How to use this checklist

Work one claim at a time, in order — each step depends on the one before it. Your ticks and notes stay saved in this browser until you choose “Start a new claim.” Use “Download my completed copy” to keep a record of the claim you just reviewed, or “Download PDF” for a blank or completed printable version.