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Automating Billing & Revenue Cycle Management¶

Overview¶

The Billing & RCM (Revenue Cycle Management) module in 4Geeks Health automates claims processing, patient billing, and financial tracking. With built-in coding assistance, you can maximize reimbursement and reduce errors.

In this tutorial, you will:

• Configure billing settings and fee schedules
• Create and send patient invoices
• Process insurance claims
• Track payments and outstanding balances
• Generate financial reports

Prerequisites¶

• 4Geeks Health account with Billing Staff or Administrator role
• Fee schedule for your services
• Insurance payer information
• Understanding of your billing workflow

Step 1: Configure Billing Settings¶

Fee Schedule¶

1. Go to Billing → Fee Schedule
2. Add your services and prices:

1. Set discount rules:
2. Self-pay discount percentage
3. Early payment discount
4. Package deal pricing

Insurance Payers¶

1. Go to Billing → Insurance Payers
2. Add insurance companies:
3. Payer name: Insurance company
4. Payer ID: Standard identifier
5. Contact information: Claims address, phone
6. Electronic claims: Enabled/disabled
7. Contracted rates: Negotiated rates per service

Billing Rules¶

1. Go to Billing → Settings
2. Configure:
3. Default payment terms: Due on receipt, Net 30, etc.
4. Late fee policy: Percentage and grace period
5. Auto-billing: Generate invoices automatically after consultation
6. Receipt generation: Auto-send receipts to patients

Step 2: Create Patient Invoices¶

Auto-Generated Invoices¶

When auto-billing is enabled, invoices are created automatically after each consultation:

1. Provider completes the consultation
2. System generates invoice based on:
3. Services rendered (from consultation notes)
4. CPT codes assigned
5. Patient’s insurance coverage
6. Applicable discounts
7. Invoice is sent to patient via email/SMS
8. Insurance claim is submitted (if applicable)

Manual Invoice Creation¶

1. Go to Billing → Invoices → New Invoice
2. Select the patient
3. Add line items:
4. Service: Select from fee schedule
5. Quantity: Number of units
6. Price: Auto-filled from fee schedule (editable)
7. Tax: Auto-calculated based on location
8. Apply insurance:
9. Insurance provider: Select from payer list
10. Policy number: Auto-filled from patient record
11. Estimated coverage: System calculates based on contracted rates
12. Review and send

Invoice Components¶

┌─────────────────────────────────────────────────┐
│ 4Geeks Health - Invoice                         │
│ Invoice #: INV-2026-001234                      │
│ Date: March 10, 2026                            │
│ Due Date: April 9, 2026                         │
├─────────────────────────────────────────────────┤
│ Patient: Jane Smith                             │
│ ID: PAT-005678                                  │
├─────────────────────────────────────────────────┤
│ Description          Qty  Rate    Amount        │
│ General Consultation  1   $150.00  $150.00      │
│ Lab Test - CBC        1    $45.00   $45.00      │
├─────────────────────────────────────────────────┤
│ Subtotal:                    $195.00             │
│ Insurance Adjustment:        -$75.00             │
│ Patient Responsibility:      $120.00             │
│ Tax:                          $12.00             │
│ ─────────────────────────────────               │
│ Total Due:                   $132.00             │
├─────────────────────────────────────────────────┤
│ Insurance Claim: Submitted (Claim #CLM-009876)  │
│ Expected Insurance Payment: $75.00              │
└─────────────────────────────────────────────────┘

Step 3: Process Insurance Claims¶

Electronic Claims Submission¶

1. Go to Billing → Claims
2. Review pending claims
3. Select claims to submit
4. Click “Submit Claims”
5. Track claim status:

Handling Denied Claims¶

1. Go to Billing → Claims → Denied
2. Review denial reason:
3. Coding error: Incorrect CPT/ICD-10 code
4. Missing information: Required data not provided
5. Not covered: Service not covered by plan
6. Prior authorization: Authorization required but not obtained
7. Correct the issue
8. Resubmit the claim
9. Track the resubmission

Coding Assistance¶

The system provides real-time coding suggestions:

• ICD-10 suggestions based on diagnosis
• CPT code suggestions based on procedures performed
• Bundling alerts when services should be billed together
• Unbundling alerts when services are incorrectly separated

Step 4: Track Payments¶

Payment Recording¶

1. Go to Billing → Payments → Record Payment
2. Select the invoice
3. Enter payment details:
4. Payment method: Cash, card, bank transfer, insurance
5. Amount: Full or partial payment
6. Reference: Transaction ID, check number
7. Date: Payment date
8. Click “Record Payment”

Payment Status Tracking¶

Aging Reports¶

Go to Billing → Reports → Aging to view:

Step 5: Generate Financial Reports¶

Available Reports¶

Export Options¶

• PDF: For printing and sharing
• CSV: For spreadsheet analysis
• Excel: With pre-formatted tables and charts

Best Practices¶

Revenue Optimization¶

• Submit claims within 24 hours of service
• Verify insurance eligibility before appointments
• Collect co-pays at time of service
• Follow up on denied claims within 48 hours
• Review fee schedules annually and adjust for inflation

Error Reduction¶

• Use coding assistance to minimize coding errors
• Double-check patient information before submitting claims
• Review claims before submission for completeness
• Train billing staff on common denial reasons and prevention

Compliance¶

• Maintain audit trails for all billing transactions
• Follow HIPAA guidelines for patient financial data
• Keep records for the required retention period
• Stay updated on coding standard changes (ICD-10, CPT updates)

What’s Next?¶

• Learn about Patient Portal Setup
• Explore Inventory & Procurement Management
• Read about Processing Payments via 4Geeks Payments

Need Help?¶

• Documentation: docs.4geeks.io/en/health
• Support: Available through the platform
• Book a Demo: 4geeks.io/en/contact

Still questions? Ask the community.