Workflow Ready
EOB Reading Workflow
A fictional workflow for locating claim-processing details on an EOB and identifying questions for follow-up. It usually involves Medical billers, AR follow-up specialists, and patient-balance staff. and appears during Payment / EOB / ERA, Patient Balance / Statement.
Claim Rejection vs Claim Denial
Identify where a rejection and denial occur and read the actual response before choosing a next step. This beginner module connects the concept to Claim Submission, Denial / Rejection Review, Correction / Appeal and includes a fictional practice activity.
AR Follow-Up and Denial Basics
Turn a verified claim status into a documented, policy-aligned next action. This beginner module connects the concept to Claim Status, Denial / Rejection Review, Documentation / Follow-Up and includes a fictional practice activity.
Eligibility and Benefits Basics
Separate eligibility status from benefit detail and document the source and date. This beginner module connects the concept to Insurance Verification, Benefits Check and includes a fictional practice activity.
Deductible, Copay, Coinsurance, and OOP Max
Explain common cost-sharing terms without calculating or guaranteeing final responsibility. This beginner module connects the concept to Benefits Check, Patient Balance / Statement and includes a fictional practice activity.
Claims and Billing Basics
Describe how a claim moves from documented service to payer processing and follow-up. This beginner module connects the concept to Coding Review, Claim Submission, Claim Status and includes a fictional practice activity.
CMS-1500, CPT, ICD-10-CM, and HCPCS Intro
Recognize basic claim-form and code-set concepts without claiming coding authority. This beginner module connects the concept to Coding Review, Claim Submission and includes a fictional practice activity.
EOB, ERA, and Payment Basics
Locate processing information and distinguish an EOB, ERA, provider bill, and payment. This beginner module connects the concept to Payment / EOB / ERA, Patient Balance / Statement and includes a fictional practice activity.