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 adds your payers (looking up each Payer ID in the clearinghouse directory), your billing codes with the insurance rate and the cash rate, each provider's NPI and taxonomy, and your billing-provider details, one card at a time for you to approve. 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.
When a provider can't bill under their own NPI
Some of the people who deliver billable care don't hold an NPI — massage therapists and technicians commonly don't. A claim still has to name a provider the payer can look up, because the claim format has no field for "who physically performed this service." So instead of leaving those visits unbillable, you tell Ready Practice who that person bills under.
The same applies to a provider who has an NPI but isn't enrolled with your payers yet. Credentialing often runs for months after someone starts, and their visits go out under a supervising provider until it completes.
Open the staff member's profile and, under Provider Credentials, choose a provider in Bills under. The list offers only colleagues who have an NPI on file. From then on, their visits are claimed under that provider's NPI and taxonomy, and the claim screen shows them as "bills under" with that provider's name so the substitution is visible to whoever files it.
Revenue reporting does not move with the NPI. The visit still reports against the person who delivered the care, so your production numbers by provider stay accurate even though the payer sees the supervising provider on the claim.
Whether a particular service may be billed under a supervising provider's NPI depends on the payer, your state, and the service itself — Medicare treats this narrowly. Setting Bills under makes the arrangement possible in Ready Practice; it does not certify that a given claim is appropriate. Confirm the rules with your payers before you use it.
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.
Below the billing method sits Related to an accident?. Leave it at No for ordinary visits. For a client being treated after an auto accident, a work injury or another accident, pick the cause and enter the accident date, and for an auto accident the state it happened in. Every claim filed on that policy then carries the related cause and the date, which is what lets the payer route liability correctly; a chiropractic or physical therapy payer will often reject or delay an accident claim that omits them.
Claims also report the amount the client has already paid toward the visit automatically. Ready Practice reads it from the client's Balance, so a courtesy-bill client who prepaid and whose visit charge has been settled files with that amount on the claim, with nothing extra to enter.
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.
The claim itself is one table for the visit, opened from the client's Billing tab with Add → Insurance claim. Pick the visit at the top and the table fills in from the visit's note: the diagnoses, numbered in order, and one row per procedure with its units, the diagnosis numbers it points at, its modifiers, and the rate and charge from your billing-code library. Every cell is editable, and a visit without a coded note starts from an empty table, the booked service's default codes, or a prior claim you copy. What you change here is what the claim carries: on a visit that has a note, the edits are saved to the visit's draft superbill as you make them, survive a later re-save of the note, and show up the same way in Billing → Ready to bill, where Review & submit opens the same table for each claim so a biller fixes it there and the claim re-checks itself. The fix also reaches the visit's note: on a note that isn't signed yet, the changed codes, units, modifiers and diagnosis pointers are written onto the note, and the note's history records who changed the coding and what it was before. A signed note stays locked; instead a Coding correction addendum is added under it, in the biller's name, listing what changed, and the claim keeps the corrected coding. If the provider later changes a code, unit, or pointer on the note, the note's value wins for that field. Below the table, the Claim check lists what the scrubber found, with one-click fixes where there is one (a category-only diagnosis, a missing modifier 25), and a summary of who the claim bills as, which payer it goes to, and the date of service. The date of service and the rendering provider are set in the header, and the provider list only offers staff who carry an NPI or bill under someone who does.
Chiropractic and therapy claims need the condition's onset date, which is the day the client's current problem started — payers use it to judge whether the care is reasonable for how long it has been going on. You record it while charting, not on a separate screen: every clinical note opens with a Primary condition line naming what the visit addressed, and that condition carries the onset.
The first time you treat a new problem, the line reads Primary condition — none recorded. Add the condition treated. Click it, name the condition ("Lumbar strain"), and either pick the onset date or choose Gradual — no specific date for a problem that came on slowly. Where onset is gradual there is no start date to give, so the claim carries the date of the client's first treatment instead. The condition is added to the client's Conditions & Issues list, and the note records which diagnoses it came from.
After that there is nothing to do. When the client has one active condition the note selects it for you and simply states it; when they have several, pick the one the visit principally addressed.
Some evaluation templates also ask for the condition's start date as a question in the note itself. Answering it sets the onset on the note's primary condition when you save, so the Primary condition line, the client's Conditions & Issues list, and the claim all show the date you entered — there is one onset for the condition, never a second copy on the note. Re-saving an older note without changing that answer leaves the condition alone, so a date you later correct on the condition stays corrected. If the note has no primary condition selected, the answer has nowhere to go yet, and the note's Check claim says so: choose the primary condition at the top of the note and save again, and the date moves onto it.
You only do this once per condition. Every clinical note then shows a primary condition line at the top with that condition's onset beside it, carried through each successive visit without anyone re-entering it, and the claim files that onset. When the client has a single active condition the note selects it for you; when there are several, pick the one this visit principally addressed. If a new injury occurs, add it as a new condition with its own onset — the earlier one stays on the record and past claims are unchanged.
A visit can of course treat more than one problem, and all of its diagnosis codes still go on the claim. The onset is singular because the claim format is: a professional claim carries up to twelve diagnoses but only one start date. So a session covering both a lower-back strain and a hip problem files every code with the primary condition's onset. Where the two are genuinely separate cases — a personal-injury claim alongside a pre-existing complaint, each with its own start date and often its own payer — bill them as two claims.
If you reach the claim before anyone has recorded it, you aren't sent away to find it: the warning in Review & submit — and the same warning in a note's Check claim — carries the date field right there. Set it and it saves to the client, so that claim and every future one for them is complete. A claim filed without an onset date usually still goes through, but most payers answer with a CO-16 information request, which means waiting and resubmitting.
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.
Both places give the same checks and fixes. Whether you file from the client's chart or from Review & submit in the Billing workspace, you see who the claim bills as and which provider number it goes out under. You can add modifier 25 to an exam billed with a same-day procedure in one click, swap a non-billable diagnosis for its billable code, raise a code's rate to what the payer usually allows, and set a missing onset date. When the client's covered visits look used up, or a prior authorization is nearly or fully used, both places warn you and offer Collect self-pay instead, which posts your cash rate to the client's balance and takes the claim out of the queue. These are warnings, not blocks, because your visit count isn't the payer's own record.
When remittances come back, the Reconciliation tab groups them the way your bank statement does — by deposit. Each payer payment (an EFT or a check, identified by its trace number) appears once, with every claim it paid listed underneath: what was billed, what the payer paid, what was written off, what the client still owes (patient responsibility), and whether the numbers balance. A deposit where everything adds up reads fully posted ✓; anything that doesn't reads needs review with the payer's reason code, so nothing has to be checked twice. Pick a month with the arrows at the top — when every deposit in it is posted or explained, the month shows Month reconciled ✓, which is your month-end close against the bank statement.
From any claim row you can Post to balance — which puts the patient-owed amount on the client's account so you can collect it — and from a deposit you can Mark reconciled once it matches your bank statement (checks also get Mark deposited, since only you know when a mailed check cleared). Every one of these marks records who made it and when, both on the deposit and in the clinic activity log. Matched remittances also appear right on the client's own Billing tab, so their record shows the full picture.
To see who owes you money, click the Client A/R figure at the top of the Billing workspace, or switch Bill & Collect to Client balances. Each client who owes appears once, with their balance split into cash-pay charges and insurance share (what a payer left for the client to pay, such as a copay or deductible), along with the oldest open charge, their last payment, any invoices already sent, and how much has been open for more than 30 days. Account credit and prepaid money are already subtracted, so the list adds up to the Client A/R figure and matches each client's own Billing tab. Click a client's name to open their Billing tab and collect.
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.
The auto-invoice sends each client one invoice covering the charges that are open at that moment, exactly as if you had pressed Send invoice on their payment tab. Those charges then show as invoiced until the client pays, at which point they close on their own. An invoiced charge can still be settled at the desk: tick it in the settle window (it is marked ON INVOICE and is not pre-ticked), and paying it cancels the emailed invoice so the client cannot pay twice; an invoice that covers several charges is settled or left whole, never split. A charge that has already been invoiced is never billed again by a later run: a later run only invoices charges added since. The client still gets one email, not one per invoice — it opens with their balance as of that day and lists every unpaid invoice (the new one and any older ones), each with its own Pay button, so nobody has to find an earlier email. The same email is used when you press Send invoice yourself and when a reminder goes out. Credit on the account is shown and subtracted from the balance. Account credit is subtracted from the invoice and used up. A client who holds prepaid money, or whose charge has been partly paid from prepaid money, is left out so that staff can apply the money and collect the remainder. A client with an active package is also left out, so that staff can confirm the open charges are not covered by the package. A client with no email address cannot be invoiced. If an invoice cannot be created for a client, for example because your Stripe account collects tax and the client has no address, their charges stay open and the next run tries again.
The automation can also remind clients who have not paid. Set Remind unpaid invoices every to a number of days, and each run re-sends any invoice that is still unpaid that many days after it went out, or after its last reminder. The client receives the same invoice email again, with the same payment link, so nothing new is charged. Up to sets how many reminders one invoice can get; the default is 3. An invoice that has been paid or cancelled is never re-sent. Reminders are off until you set a number of days.
Require a signed note before filing claims (Settings → Insurance & Billing) holds any claim whose visit note isn't signed yet — the Ready-to-bill queue shows exactly which note needs a signature. And on a client's insurance policy, entering Visits Approved next to a prior-authorization number makes Ready Practice count filed claims against the authorization and warn you before you bill a visit it no longer covers.
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 appears in the same Reconciliation tab instead of being dropped, in the deposit it arrived with. Link it to the right client, then Post to balance or Mark reconciled so the payment detail isn't lost.
I. Catch visits that never got billed
A visit that was delivered but never coded earns nothing, and it is the easiest revenue in the practice to lose — nobody goes looking for a charge that was never created. Ready Practice looks for them on your behalf.
On Bill & Collect, alongside your draft claims, you'll find every completed, insurance-billable appointment from the last 60 days that produced no charge. They sit in the same table as your drafts, tinted amber so they read as work still to do, and the filter chips at the top let you show All, just Drafts, or just Uncoded. The count and the estimated value are shown together — "12 uncoded · ~$1,840" — so you can see what is sitting there before opening anything.
What makes a visit eligible is the appointment, not the note: the service must allow insurance billing and the client must be billed through insurance. A note you wrote purely for the record can never appear here.
Each row links straight to the work — Open note where a note exists, Open visit where one doesn't. Coding the note turns the row into a draft claim automatically, and it moves into your normal Ready-to-bill flow.
Some of these visits genuinely should not be billed. Select one or several and choose Won't bill, which asks for a reason before it will dismiss anything — pick No-charge visit, Comped by the practice, Billed outside Ready Practice, or Not a billable encounter, or type your own. The reason, who dismissed it, and when are all recorded, so a visit never disappears from your revenue without an answer attached. Dismissing is reversible if you change your mind.
Sixty days is the window you get, and payer timely-filing limits are often not much longer. A short weekly pass through Uncoded is usually the difference between billing a visit and writing it off.
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
- Marketplace & Shop → — sell products, lab panels, and offers.
- Billing & Costs → — understand the RCM collection fee and what else is metered.