Yes. A new practice can build most of its billing operation before seeing its first patient. The goal is to have payer enrollment, credentialing, EHR and clearinghouse configuration, fee schedules, eligibility verification, charge capture, claim submission, payment posting, and patient collections workflows tested before the first encounter.
What Should Be Ready Before Opening?
A startup practice should treat billing setup as part of its opening plan, not something to address after the first claim.
1. Establish the Billing Foundation
Confirm the practice and providers have the appropriate NPI, Tax ID, payer enrollment, credentialing, and CAQH information. Enrollment timelines vary by payer, so applications should begin well before the planned opening date.
The practice should also select and configure its medical billing services workflow, including:
- EHR and practice-management settings
- Fee schedules and payer contracts
- CPT and ICD-10 coding configuration
- Clearinghouse connections
- ERA/EFT setup
- Adjustment and denial codes
- User permissions and compliance controls
2. Test the Revenue Cycle Before Go-Live
Before the first appointment, run a complete sample workflow:
Registration → Eligibility Verification → Prior Authorization, when required → Charge Entry/Coding → Claim Scrubbing → Claim Submission → ERA/Payment Posting → Patient Balance
This test can reveal configuration problems before they affect real revenue.
Example: A new dermatology practice may discover during testing that a payer requires authorization for a particular procedure. Fixing that workflow before opening is far easier than discovering it after several claims are denied.
3. Prepare the Front Desk
Staff should know exactly how to collect insurance information, verify benefits, document referrals or authorizations, capture demographics, and communicate expected patient responsibility.
Expert Tip
An experienced billing specialist should also create a first-90-day monitoring plan before opening. Early claim denials, eligibility failures, coding errors, and unpaid balances can reveal problems in the original workflow.
The Medicator’s can help new practices establish revenue cycle management workflows before patient volume begins, giving owners a tested process for billing, collections, and A/R management from day one.
