Billing Manual
This is the working manual for billing staff at organizations using the MedSuite RCM platform. Once charges have arrived from your EMR (or wherever your clinical data originates), this manual walks you — step by step — through everything that happens between that ingested charge and a paid (or written-off) claim.
It is deliberately scoped to the billing function. Clinical attendance, EVV visits, payer configuration, and platform-admin work all live in sibling manuals; we link out where it matters but never assume you read those first.
How this manual is organized
Page template
Every chapter follows the same shape so you can scan it quickly:
- Outcome — what you'll have done after this procedure.
- Prerequisites — required RBAC scopes and predecessor work.
- Diagram — sequence or flow chart, where it helps.
- Steps — UI clicks first; CLI/SQL break-glass tucked into disclosure panels.
- Validation — how to confirm success.
- Troubleshooting — common failures and fixes.
- Next — pointer to the related next chapter.
Audience
You are likely one of:
- Billing clerk — building and submitting claims, working denials, posting remittances.
- Posting clerk — primarily working the receivables / 835 inbox.
- AR analyst — aging, days-in-AR, follow-up, claim-status inquiries.
- Billing supervisor — assigns work, runs dashboards, signs off on appeals and write-offs.
Every chapter calls out the RBAC scope it requires under Prerequisites. If the button is greyed out, that's where to look.
The shape of the day
The platform is designed so that a typical billing-staff day looks like this:
Chapter 1.2 (The billing pipeline) goes deeper on what each stage is actually doing under the hood; the rest of the manual is the field guide.
Other manuals
- Tenant Manual — broader user manual for clinical, configuration, EVV, members, and reporting. Use it when you need to understand the systems that feed billing — a charge's upstream history, a member's COB ladder, a payer's configured rules.
- EDI Manual — deep reference for X12 (837, 270/271, 276/277, 278, 835, 999, 277CA). You usually do not need it; we surface what you need to know in plain English here. When you do need to read raw segments, that manual is the source of truth.
- Platform Admin Manual — for MedSuite operators of the platform itself. Not a billing-team resource.
Where to start
Pick the Day 1 page that matches your role:
| Role | Start at |
|---|---|
| New to the app entirely | 1.1 — Welcome & UI tour |
| Want the big picture first | 1.2 — The billing pipeline |
| Building & submitting claims | 1.3 — Day 1 as a billing clerk |
| Posting ERAs | 1.4 — Day 1 as a posting clerk |
| AR follow-up & aging | 1.5 — Day 1 as an AR analyst |
| Running the team | 1.6 — Day 1 as a billing supervisor |
If you are coming back to look something specific up, the sidebar mirrors the diagram above — every category collapses cleanly.