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Powered by StealthAgentsCharge and claim preparation
Assemble the encounter information the practice has approved, check for missing required fields, and prepare claims for submission in the practice's billing system.
Practice workflow
Medical Billing and Revenue Cycle
A steadier claims queue, from charge review to denial follow-up.
A billing assistant works the parts of the revenue cycle that depend on consistent follow-through: claim preparation, status checks, denial documentation, payment posting, and patient balance outreach.
Who this is for
Built for the practice where you are still the backup.
This role fits a small practice that needs reliable administrative follow-through without adding another management layer.
- A solo physician who still reviews the aging report personally
- A small practice whose billing company is slow to answer questions
- An office manager covering billing, scheduling, and front-desk work at once
Claims sit until someone remembers them
A clean claim is not the end of the work. Status checks, missing documentation, and payer follow-up have to happen on a cadence or the aging report quietly grows.
Denials arrive without a clear owner
A denial needs the payer reason, the supporting record, the corrected claim or appeal, and a follow-up date. Without that trail, the same denial is worked twice or not at all.
Patient balances become an afterthought
Statements, payment questions, and balance outreach compete with the clinical day. A defined administrative owner keeps the conversation moving without turning the physician into a collections desk.
Scope of work
What the assistant actually handles.
Each item below is documented before the role starts. The practice approves the boundaries, the systems, and the review points.
Payer status follow-up
Check claim status on a scheduled cadence, record payer reference numbers, and surface claims that need records, corrected information, or a practice decision.
Denial intake and documentation
Read the denial reason, organize the supporting documentation, and prepare the appeal or correction packet for practice review before submission.
Payment posting support
Post approved remittance details, flag discrepancies, and maintain a reconciliation note so the practice can review the month without rebuilding the paper trail.
Aging and balance follow-up
Work the aging report in priority order, prepare patient balance outreach, and document the contact outcome and next step.
Billing calendar and closeout
Maintain a weekly billing calendar with open items, deadlines, payer escalation notes, and a clear list of decisions that require the physician or billing lead.
What we need from you
Inputs before the first handoff.
- Read-only or role-based access to the billing system
- The practice's charge, modifier, and submission rules
- Payer portal access approved by the practice
- A named billing reviewer for escalated decisions
- The current aging report and a sample of recent denials
What you receive
Deliverables the practice can review.
- A weekly claims status and denial worklist
- Documented appeal and correction packets ready for review
- A payment posting and reconciliation note
- Patient balance outreach records with next steps
- A short end-of-week summary of what moved and what is blocked
A realistic workflow
How the work runs in a normal week.
The cadence is intentionally simple. Each checkpoint has a task, a record, and a clear handoff when something needs a practice decision.
Before the week
Review the open balance
Sort the aging report by age and value, identify claims with no recent activity, and confirm which items need records, a correction, or a practice decision.
Early week
Work denials and missing information
Pull the denial reason and supporting documentation, prepare the response, and send the items that are ready for the practice's required review.
Midweek
Check status and post payments
Follow up on submitted claims, record payer reference numbers, post approved remittances, and flag any payment that does not match the expected allowed amount.
End of week
Close the loop
Update the worklist with next follow-up dates, surface the claims at risk, and give the practice a concise note on decisions needed next week.
Quality controls
How the practice checks the work.
The assistant is not a black box. The role leaves a record that the practice can review, question, and correct.
- Every claim touch has a date, a reference number, and a next action
- Appeals and corrections are reviewed by the practice before submission
- Payment discrepancies are flagged rather than silently adjusted
- The weekly worklist is compared against the aging report for gaps
Boundaries
What stays with the practice.
A clear boundary protects the patient relationship and keeps the administrative role focused.
- Coding and medical-necessity decisions remain with the qualified billing or clinical reviewer
- The assistant does not change a diagnosis, procedure code, or modifier without approval
- Patient financial conversations follow the practice's written policy
- Refunds, write-offs, and settlement decisions require practice authorization
Common starting points
Where practices usually begin.
These are illustrative operating scenarios, not client case studies. They show how the role is scoped when the queue is already behind.
The denial backlog
A practice has 60 unresolved denials and no consistent owner. The first month focuses on sorting by denial reason, preparing the straightforward appeals, and creating a weekly cadence for the rest.
The aging report drift
Claims are submitted but not checked. The assistant introduces a Monday status review and a Friday escalation note so unpaid claims do not disappear into the report.
The patient balance question
Front-desk staff are answering billing questions between check-ins. A defined balance outreach block and a written escalation path move those conversations into a reliable administrative process.
Questions before you start
Practical answers, without the sales language.
If a question is not answered here, bring it to the consultation. We will tell you if the workflow is not a fit.
Does the assistant do medical coding?
The role supports the billing workflow, but coding and medical-necessity decisions stay with the qualified coding or clinical reviewer. The assistant can prepare information, identify missing fields, and route questions.
Can you work with our current billing software?
Yes, if the practice can provide role-based access and approve the workflow. The onboarding starts with a short systems and permissions review before any work begins.
Will the assistant contact payers directly?
Payer contact is scoped with the practice. Some practices approve portal checks and status calls; others keep payer calls in-house and use the assistant for preparation and documentation.
How do you measure whether it is working?
We agree on a small set of operational measures before the start: claims touched, denials documented, follow-up dates recorded, and open items cleared. We do not promise a revenue percentage.
Start with one workflow
Ready to scope medical billing and revenue cycle?
Bring the queue, the systems, and the boundaries you already know. We will help turn them into a defined administrative role.