Track · Billing & RCM

Billing & RCM

The Revenue Cycle worklist, working a denial from the payer's own remittance, a patient's account end to end, and where claims actually come from.

4 lessons · 29 minutes · Billers, RCM staff and practice managers

Lessons

Take them in order the first time. After that, use this page as a reference index.

  1. 01 The Revenue Cycle worklist A/R aging, every claim's status, and the work items that are the only place anything actually gets done. 7 min
  2. 02 Working a denial The remittance, the AI's rework plan, and why the badge above it is the most important thing on the screen. 8 min
  3. 03 A patient's account The two balances, what each claim actually paid, and printing a statement the patient can understand. 8 min
  4. 04 Where claims come from A claim is born when a clinician signs off — which means most billing problems are really documentation problems, upstream. 6 min

When you finish this track you can

  • Read A/R aging and every claim status
  • Work a denial from the 835 rather than from a summary
  • Explain any patient balance from the claim row
  • Trace a recurring denial back to its upstream cause