Workflow Ready

Tools and Systems Basics
Recognize common tool categories and follow employer-approved access, security, and documentation practices. This beginner module connects the concept to Documentation / Follow-Up and includes a fictional practice activity.
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New Patient Intake Workflow
A safe administrative sequence for receiving and checking new-patient information through approved systems. It usually involves Medical VAs, schedulers, and receptionists. and appears during Patient Intake.
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Insurance Eligibility Verification Workflow
A fictional workflow for confirming plan identity and eligibility status for the relevant date. It usually involves Medical VAs, schedulers, receptionists, and medical billers. and appears during Insurance Verification.
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Benefits Verification Workflow
A service-aware workflow for reviewing stated benefit information without guaranteeing final payment or responsibility. It usually involves Medical VAs, medical billers, and schedulers. and appears during Benefits Check.
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Prior Authorization Tracking Workflow
A status-tracking workflow for stated authorization requirements, submissions, responses, and next actions. It usually involves Prior authorization VAs and Medical VAs. and appears during Referral / Authorization, Documentation / Follow-Up.
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Referral Handling Basics
A beginner workflow for checking, receiving, routing, and tracking referrals without confusing them with authorization. It usually involves Medical VAs, schedulers, receptionists, and prior authorization VAs. and appears during Referral / Authorization, Scheduling.
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Claim Submission Overview
A high-level, non-coding-authority overview of preparing and sending a claim through approved billing systems. It usually involves Medical billers and authorized claims support staff. and appears during Coding Review, Claim Submission.
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Claim Status Follow-Up Workflow
A fact-based workflow for checking claim status and recording a defensible next action. It usually involves Medical billers and AR follow-up specialists. and appears during Claim Status, Documentation / Follow-Up.
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Denial Review Workflow
A workflow for reading the actual denial response, identifying the stated reason, and routing the issue safely. It usually involves Medical billers and AR follow-up specialists. and appears during Denial / Rejection Review, Correction / Appeal.
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Corrected Claim vs Appeal Decision Flow
A beginner decision flow for distinguishing an approved correction route from an appeal route. It usually involves Medical billers and AR follow-up specialists. and appears during Correction / Appeal.
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