Knowledge hub

Medical billing, explained in plain English.

59 short answers to the questions billers actually ask: what a claim really is, why a payer denied it, where the money lives, and what to do next. No jargon, no fluff — the same explanations we teach our own team.

Getting around

How the app is laid out and what the assistant can (and cannot) do on its own.

Billing basics

The vocabulary every biller needs: claims, payers, codes, write-offs, NPIs.

Patients & accounts

Adding patients, guarantors, credits, and what lives on a patient record.

Creating claims

Turning charges and paper into claims, by hand or with help.

The claims list

Reading claim statuses, saved views, and how to start a billing day.

Payer enrollments

Getting a provider approved to bill a payer, and reading enrollment statuses.

Denials & appeals

What to do when a claim comes back denied, and which codes to expect.

Getting paid

Remittances, patient responsibility, write-offs, and short checks.

Provider groups & fees

Provider groups, fee schedules, and clearinghouse registration.

Automations

What the automations do and how to set up monthly eligibility re-checks.

Reports

Which report answers which question, and sending a practice its numbers.

Team & trust

Inviting teammates, roles, and what the assistant has been doing.

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Medical billing, explained in plain English.

Getting around

How is every page laid out?

What can the assistant do, and does it ever act on its own?

Billing basics

What is a claim?

What is a charge?

What is a payer?

Who is the guarantor?

Copay, deductible, coinsurance: what is the difference?

What is the allowed amount, and what is a write-off?

What is a remittance, and how is it different from an EOB?

What is a denial code?

Eligibility and prior authorization: what is the difference?

What is a clearinghouse?

What is an NPI, and whose is it?

What are CPT, ICD-10 and place-of-service codes?

Where does billing money actually leak?

Patients & accounts

What is on a patient record?

How do I add a new patient?

What is a credit, and what can I do with it?

How do I change who is responsible for a bill?

What if a patient has no insurance card?

Creating claims

How do I create a claim by hand?

Can I bill charges that are already on the account?

Can I just ask the assistant to create a claim?

How do I turn a stack of paper into claims?

What do the colours mean on the bill import review table?

What is a draft claim, and when does it actually go out?

The claims list

How do I read the claims list?

What does each claim status mean?

What is a saved view, and why would I want one?

How should I start my billing day?

Payer enrollments

What is a payer enrollment, and do I need one for every payer?

What do the enrollment statuses mean?

The payer is asking for more. What are enrollment tasks?

Denials & appeals

A claim came back denied. What do I do?

Which denial codes will I meet most?

How do I find out why a claim was really denied?

What if the coverage was not active that day?

What is a corrected claim?

Getting paid

Where does the money live: on the claim or on the account?

What happens when the payer pays?

Why does the patient owe the whole bill?

How do I take a payment at the front desk?

A paper check arrived. How do I post it?

Why is this check short?

When does money have to go back out?

What is a patient statement, and when does one go out?

How do two insurances work?

How do I know if a payer underpaid me?

Provider groups & fees

What is a provider group?

What is a fee schedule?

How do I build a price list?

What does registering a group with the clearinghouse do?

Automations

What is an automation?

How do I re-check everyone's insurance every month?

Reports

Which report answers which question?

How do I send a practice their numbers?

Team & trust

Where did this number come from?

What has the assistant been doing, and what did it cost?

How do I invite a teammate, and what do the roles mean?

Everything on this page is a screen in NxtPivot. See it work on your own claims.