Practice Billing Readiness Checklist
A one-page review of registration, eligibility, coding, claims, posting, denials and reporting practices.
Download Word document ↗RESOURCESPractical resources
Practical resources
for busy practices.
Checklists, trackers, a plain-language glossary and guides for practice owners, administrators and billing teams. Adapt each one to your own policies, payers and applicable rules.
FREE DOWNLOADS
Checklists and trackers for your team.
Starter templates for internal adaptation. Never store patient information in shared copies.
Credentialing Document Checklist
Documents and details to gather for provider credentialing and payer enrollment.
Download Word document ↗New Patient Registration Checklist
Fields to capture and verify at registration so claims start clean.
Download Word document ↗Billing Company Evaluation Scorecard
A scoring sheet for comparing billing companies side by side.
Download Word document ↗Claim Denial Tracking Sheet
Log denials by payer, reason and amount, with an appeal status and a recovered-amount total.
Download Excel sheet ↗A/R Follow-Up Log
Track unpaid claims, call notes, next action dates and aging in days.
Download Excel sheet ↗BILLING GLOSSARY
Plain-language definitions.
The terms you see on remittances, reports and payer letters.
A/R (accounts receivable)
Money owed to the practice for services already provided, by payers and patients.
Adjustment
A change to the billed amount, such as a contractual write-down agreed with a payer.
Clean claim
A claim that can be processed without rejection or correction on the first submission.
Clearinghouse
A service that checks and passes electronic claims between providers and payers.
Coordination of benefits (COB)
Rules that decide which payer is primary when a patient has more than one plan.
CPT code
A numeric code describing a medical service or procedure.
Credentialing
The process payers use to verify a provider's qualifications before enrollment.
Days in A/R
An estimate of how long, on average, it takes to collect payment after a service.
EOB / ERA
An explanation of benefits (paper) or electronic remittance advice showing how a payer processed a claim.
ICD-10 code
A code describing a patient's diagnosis or condition.
Modifier
A two-character addition to a code that gives more detail about how a service was performed.
Prior authorization
Approval from a payer, requested in advance, for certain services.
Remittance
The payment and explanation a payer sends after processing a claim.
Superbill
A form listing the services provided at a visit, used to capture charges.
Timely filing
The deadline by which a claim must be submitted to a payer.
Underpayment
A payment that is lower than the amount the contract allows.
SYSTEMS & SOFTWARE
What to look for in the tools you use.
Features and questions that matter more than brand names.
EHR and practice management systems
- Look for clean charge capture, claim edits and reporting.
- Ask how easily billing staff can work inside the system.
- Confirm how data can be exported if you ever switch.
Clearinghouses
- Check payer coverage for the payers you actually bill.
- Ask about claim-scrubbing edits and rejection reports.
- Confirm ERA and eligibility check support.
Patient payment tools
- Look for clear statements and several payment options.
- Ask about secure payment handling and reporting.
- Check whether payment plans are supported.
Documents and tracking
- A shared tracker can manage authorizations and follow-up lists.
- Use claim numbers, not patient names, in shared files.
- Restrict access to people who need it.
Reporting and analytics
- Start with collections, denial rate, days in A/R and charge lag.
- Define each metric the same way every month.
- Review trends, not single months.
Security basics
- Use unique logins and multi-factor authentication where available.
- Limit access by role and review it regularly.
- Never send patient information by ordinary email or web forms.
CHOOSING A PARTNER
Questions to ask any billing company.
A practical due-diligence checklist before you sign.
Confirm the business
- Verify the company, leadership and working contact details.
- Ask for references from practices of a similar size and specialty.
- Confirm who your named contact will be.
Confirm the process
- Ask how they handle denials, appeals and A/R follow-up.
- Request sample reports and a description of onboarding.
- Clarify who approves write-offs and patient communication.
Confirm security and terms
- Ask how patient information is protected and what agreements are used.
- Understand pricing, what is included and what costs extra.
- Know the notice period and handover process if you leave.
FIELD GUIDES
Short references for everyday billing.
Each links to a guide or template you can use today.
Denial management guide
Categorize denials, find root causes and decide what to appeal.
Read the guide ↗A/R aging guide
How to read the 30, 60, 90 and 120+ day buckets.
Read the guide ↗Credentialing checklist
Documents and steps for provider enrollment.
Download checklist ↗Clean claim guide
Why first-pass acceptance matters and how to raise it.
Read the guide ↗Prior authorization practices
Identify, document, track and follow up on approvals.
Read the guide ↗Patient balance guide
Clear statements and courteous follow-up.
Read the guide ↗NEED A HAND?
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