Step 7 — Insurance & Billing (RCM)
This step turns on revenue-cycle management (RCM) — everything involved in getting paid by insurance instead of collecting the full fee from the client. By the end you'll be able to check a client's coverage, book a visit that bills their insurance (no card needed), file the claim, and reconcile the payment when it comes back.
You only need this step if you bill insurance. A cash-pay coaching practice can skip it entirely and mark it skipped in the setup wizard.
Say "Atlas, set up my insurance billing" and it will add your payers, fill in your billing-provider details, and walk you through your first eligibility check and claim. This page is the reference for each piece — do it yourself, or let Atlas do it with you.
Everything below lives under Settings → Insurance & Billing, which is organized into five tabs: Insurance Providers · Billing Codes · Provider Credentials · Billing Provider · ERA Enrollment. Work through them in order the first time — later tabs depend on the earlier ones.
A. Add the payers you work with
A payer is the insurance company that reimburses you — Aetna, Blue Cross, Medicare, and so on. Before anything else can bill insurance, Ready Practice needs to know which payers you accept, because every client's policy and every claim links back to one of them.
Go to Settings → Insurance & Billing → Insurance Providers → Add Provider, and for each payer enter its name and its Payer ID — the clearinghouse's unique identifier for that company (for example, Aetna is 60054). The Payer ID is how claims are routed to the right insurer, so it has to match the clearinghouse exactly; it is not the payer's mailing address.
A client's insurance policy links to a payer by name. If you import clients before their payers exist here, those policies won't link — so add all your payers first.
Don't know a Payer ID? Ask Atlas "what's the payer ID for [insurance company]?" and it will look it up.
B. Enter your billing codes
Claims describe what you did and why using standardized codes. Setting yours up once means every claim pre-fills with the right codes and charges instead of you typing them each time.
Under the Billing Codes tab, add the codes you bill, with your fee for each:
- CPT / HCPCS codes — the procedure codes that say what service was performed (for example, an evaluation, a therapy session, an adjustment).
- ICD-10 codes — the diagnosis codes that say why the service was medically necessary.
You can attach a default set of codes to each service, so a claim generated from that service already has the right codes on it.
C. Add each provider's credentials
Before you can submit claims, every provider who delivers billable care needs their credentials on file. Payers use these to confirm who rendered the service and what kind of provider they are — and a claim missing either one is rejected before it's even reviewed. This is a one-time setup per provider.
Under Provider Credentials, add two things for each provider:
- NPI (National Provider Identifier) — the unique 10-digit number payers use to identify a provider. This is the rendering provider, meaning the person who actually delivered the care (not necessarily the practice owner).
- Taxonomy code — a standardized code for the provider's specialty and type. A chiropractor and a physical therapist have different taxonomy codes; it tells the payer the service came from an appropriately licensed provider.
Once saved, both are pulled onto every claim for that provider automatically — you won't re-enter them per claim.
A claim submitted without a valid NPI and taxonomy for the rendering provider is denied at the clearinghouse. If you ever see "missing/invalid rendering provider" rejections, an incomplete credential here is the first place to check.
D. Set your billing provider
The billing provider is the entity money is paid to — usually your organization, not an individual. It appears on every claim as the "bill-to," so it has to be complete and accurate.
Under the Billing Provider tab, enter your organization's group NPI, Tax ID (EIN), taxonomy, and address. All four are required — a claim missing any of them won't clear.
E. Enroll for electronic remittances (ERAs)
An ERA (electronic remittance advice, the "835") is the electronic version of the explanation-of-benefits a payer sends back after processing a claim — what they paid, what they adjusted, and what the patient still owes. Enrolling for ERAs means those come back to you digitally instead of as paper checks and letters.
Under ERA Enrollment, submit enrollment for your payers. Once active, remittances flow straight into your Billing dashboard and are matched to the right client and claim automatically — no manual posting.
F. Bill a visit to insurance instead of collecting a card
By default, booking a paid service collects payment from the client. To make a service bill insurance instead, two switches both have to be on:
- On the service — turn on "Allow billing to insurance" under Settings → Services (available on 1:1 services only).
- On the client's policy — set the policy's billing method on the client's profile.
The billing method is a per-client choice that decides how Ready Practice files the claim and who the payer reimburses. You pick one of three on the Insurance panel:
- Bill insurance — you file the claim and the payer pays the practice. Use this for in-network clients.
- Courtesy bill — the client prepays, you still file the claim, and the insurer reimburses the client. Use this for out-of-network clients who want you to submit on their behalf.
- Time-of-service — the client pays your cash rate now and you hand them a superbill (an itemized, coded receipt) to submit to their own insurer. Ready Practice doesn't file anything.
Alongside the method is an Assignment of Benefits (AoB) toggle — the client's authorization for the insurer to pay the practice directly rather than paying the client. It defaults on and is turned off automatically for courtesy and time-of-service, so reimbursement routes to the client in exactly those cases.
When Bill insurance is set and the service allows it, that client books with no card collected. The visit is recorded as insurance-pending and drops into your Ready to bill queue to file. Membership-included, pay-later, and cash bookings are unaffected — this only changes the insurance path.
If a payer requires a prior authorization (their advance approval for a service) or a referral (an approval from the client's primary doctor, common on HMO plans), enter the Prior-Auth Number and Referral Number on the client's insurance policy. They flow onto every claim for that policy automatically — there's no per-claim box, and payers deny authorized-service or HMO claims that omit them.
G. Check eligibility, then file the claim
Eligibility is a real-time check with the payer that confirms a client's coverage is active before you see them — it saves you from delivering a visit that won't be reimbursed. Run it from the client's policy; Ready Practice sends a 270 request and shows you the 271 response (the payer's coverage answer), including the client's copay, coinsurance, deductible, and out-of-pocket max.
You don't have to remember to run it, though. Ready Practice re-checks coverage automatically — nightly for every insured client with an appointment the next day, and again the moment a new future appointment is booked (it skips anything checked in the last two weeks so it never wastes a check). The latest result shows up as a coverage badge on the client and on the appointment in your scheduler: a chip reading Active coverage, Inactive, or Not verified, plus in- or out-of-network, the copay, and the deductible remaining. If it's stale or missing, the badge has a one-click Re-check — it's display-only and never charges anyone.
To file a claim, submit an 837P (the standard professional claim format) from a completed visit or a superbill. Before it goes out, a pre-submission scrubber checks for the errors that cause first-pass rejections — an unlinked payer, a subscriber/dependent mismatch, a missing date of birth or address — and flags them so you fix them before the payer ever sees the claim.
When the patient is a dependent on someone else's policy, Ready Practice files it correctly — the policyholder goes in as the subscriber and the patient in the dependent loop — as long as the subscriber's details are filled in on the policy.
For time-of-service clients (those who pay you directly and seek their own reimbursement), generate a superbill — an itemized receipt with the codes they submit to their own insurer — instead of filing a claim yourself. When you issue it, the superbill PDF is saved to the client's documents automatically, so the client can retrieve it from the app or portal and submit it without asking you to re-send it.
When a client has two policies, file the primary claim first. Once it's paid, a File secondary claim button appears on that claim — it builds the secondary claim (with the coordination-of-benefits detail: what the primary paid and adjusted) from the primary's remittance, so you don't re-key anything. Add the client's secondary policy on their Insurance panel the same way you add the primary.
H. Reconcile the payments
Day to day, your billers work from the Billing workspace (/billing) instead of hunting through charts. When a provider finishes a coded visit note, Ready Practice turns it into a draft claim automatically and drops it into the Ready to bill queue. Your biller opens Review & submit, which checks each draft with the scrubber and an AI denial-risk review (Atlas flags likely denial reasons — a missing modifier, a code-pairing issue — before you file), then submits the clean ones together.
When remittances come back, the workspace shows each one: what the payer paid, what the client still owes (patient responsibility), and any denials with their reasons. From a matched remittance you can Post to balance — which puts the patient-owed amount on the client's account so you can collect it — or Mark reconciled if there's nothing to collect. Matched remittances also appear right on the client's own Billing tab, so their record shows the full picture.
To collect a balance, settle the charge on the client's payment tab by charging a card on file, sending a hosted invoice (a Stripe pay link), or recording an outside payment manually (cash, check, Venmo, Zelle). You can also turn on a scheduled auto-invoice that emails every client with an open balance.
When a payer denies or underpays a claim, it lands in a Denials & underpayments worklist with its reason decoded into plain language (from the payer's CARC/RARC codes) and a suggested next action — correct and resend, add a missing authorization, appeal, or write off. For appealable denials, Atlas can draft a payer-ready appeal letter grounded in what has overturned similar denials before. The draft is never sent automatically — you review and edit it, send it through the payer's appeals channel, and Mark appealed records the outcome.
Never re-send an identical claim — the payer rejects it as a duplicate. From the claim's detail, use Correct & resubmit to file a replacement, or Void claim to cancel one. Both automatically reference the original so the payer replaces or backs out the right claim.
If a remittance arrives for a claim Ready Practice didn't file — common while you're migrating from a previous system — it's captured under Insurance payments to reconcile in the Claims view instead of being dropped. Link it to the right client, then Post to balance or Mark reconciled so the payment detail isn't lost.
Your insurance checklist
- Every payer added with the correct Payer ID
- CPT/HCPCS + ICD-10 codes entered with fees
- Each provider's NPI + taxonomy on file
- Billing provider complete (group NPI, EIN, taxonomy, address)
- ERA enrollment submitted
- Insurance-billable services + client policies configured
- One test eligibility check run and one test claim scrubbed clean
Next steps
- Step 8 — Marketplace & Shop → — sell products, lab panels, and offers.
- Billing & Costs → — understand the RCM collection fee and what else is metered.