MEDICODE BOOTCAMP

Medical Billing Revenue Cycle
Practice Worksheet

Free Medical Billing Study Session • September 26, 2026 • 2:00–3:00 PM Eastern

Print / Save as PDFBack to Learning Center

Name: ______________________________   Date: ________________

Part 1 — Follow the Revenue Cycle

As we move through the lesson, write a short note about what happens at each stage. Use your own words.

1. Registration
What patient and insurance information should be confirmed?
2. Eligibility & Benefits
What should be verified before the visit or claim?
3. Encounter & Documentation
What information from the visit supports billing?
4. Coding & Charge Entry
What information is translated into billable claim data?
5. Claim Creation
What key information must be present on the claim?
6. Clearinghouse
What does the clearinghouse do? What can cause a rejection?
7. Payer Adjudication
What happens after the payer receives the claim?
8. EOB / ERA
What does this tell the biller?
9. Payment Posting
What gets posted to the patient account?
10. Patient Responsibility
What amounts might appropriately become patient responsibility?
11. Follow-Up / A/R
What does the biller do when a balance or claim still needs resolution?

Part 2 — Work Maria’s Account

Scenario: Maria Lopez is an established patient with commercial insurance. She comes to the office for worsening seasonal allergies. Follow her account through the billing process.
1. Maria’s insurance card is on file from last year. What should the office do before relying on it?
2. Maria’s claim is rejected by the clearinghouse because the subscriber ID is invalid. Is this the same as a payer denial? What should happen next?
3. The payer processes Maria’s corrected claim but pays less than the amount the provider billed. What should the biller review before deciding what to do with the remaining balance?
4. Name three pieces of information you might find on an EOB or ERA.
5. A claim is denied after payer adjudication. List two possible next steps for the biller.
6. In one sentence, explain why accurate information early in the revenue cycle matters.

Quick Review

A. Rejected and denied claims always mean the same thing.   TRUE / FALSE

B. If a payer pays less than billed, the entire difference automatically becomes patient responsibility.   TRUE / FALSE

C. The EOB/ERA helps explain how the payer processed the claim.   TRUE / FALSE

One thing I want to learn more about:

Educational use only. Workflows and payer requirements vary. Always use current payer requirements, applicable rules, and organizational procedures.