Medical Billing Checklists for Practices and Billing Teams

What’s included in these checklists

CureAdvantage publishes free, printable checklists for the billing and coding tasks a practice repeats every day — claim submission, insurance verification, prior authorization, charge capture, monthly and year-end audits, staff and provider onboarding, and HIPAA and OIG compliance. All 19 are PDFs, each with a direct download link below.

HIPAA Compliance Checklist

Covers the Privacy Rule items a billing office touches daily: giving every new patient a Notice of Privacy Practices, applying the minimum necessary rule, holding signed patient authorizations, answering records requests within 30 days, and keeping Business Associate Agreements on file.

Monthly Billing Audit Checklist

A month-end review of claim volume, charges entered against the appointment schedule, timely filing limits per payer, the electronic-to-paper claim ratio, and the clearinghouse rejection report. Includes fields for month, auditor, and date completed.

Claims Submission Checklist

Pre-submission verification of the patient details that most often trigger denials: legal name exactly as printed on the insurance card, date of birth, current address, relationship to the insured, and member ID formatting.

New Patient Onboarding Checklist

What to collect before a first visit: confirmed appointment, registration, history and consent paperwork sent ahead, insurance card front and back, and eligibility pre-verified through the payer portal.

Credentialing Document Checklist

The documents payers request when approving a provider to bill: a CV covering ten years with no gaps, government photo ID, Social Security verification, and proof of citizenship or work authorization. Notes that credentialing commonly runs 60–180 days.

Prior Authorization Checklist

Steps to complete before the service takes place: match name and date of birth to the card, verify coverage on the day of service rather than at scheduling, check for secondary insurance, and gather the exact CPT codes and the ICD-10 diagnosis supporting medical necessity.

Denial Prevention Checklist

Pre-submission checks on patient and provider data: name matching the card exactly, date of birth, member ID copied from the card, coverage active for the date of service, the correct payer listed as primary, and rendering and billing NPIs with Tax ID.

End-of-Day Billing Checklist

A daily close-out routine: reconcile the schedule against visits actually seen, capture walk-ins and add-ons, mark no-shows and cancellations, confirm every visit carries a CPT and ICD-10 code, and check that signed provider notes match the level billed.

Practice Revenue Health Checklist

A monthly financial review: total A/R against the prior month, A/R aging split across 0–30, 31–60, 61–90 and 90+ days, a follow-up plan for the largest outstanding balances, insurance and patient A/R tracked separately, and denial rate with its top three causes.

Payer Enrollment Checklist

Documents to gather before enrolling a provider with a payer: current state license, DEA certificate where applicable, Type 1 NPI, board certifications, ten-year work history with gaps explained, malpractice certificate, and government photo ID.

Telehealth Readiness Checklist

Technology and compliance items to confirm before seeing patients online: connection speed, a HIPAA-compliant video platform rather than a consumer app, camera and microphone testing ahead of each visit, and a quiet private location.

Year-End Billing Checklist

Year-end close-out: run an A/R aging report and sort claims by age, work everything over 90 days, document each major payer’s timely filing deadline, and appeal denied claims before they expire.

New Provider Setup Checklist

Getting a new provider billable: verify the state licence with the medical board rather than trusting a copy, confirm an active DEA registration where relevant, obtain a Type 1 NPI from NPPES, and complete the CAQH profile.

Annual OIG Compliance Checklist

Walks through a written compliance program: leadership approval, review at least annually, a named compliance officer who need not be a lawyer, coverage of billing, coding, documentation and privacy, and staff acknowledgement at onboarding.

Billing Staff Onboarding Checklist

A week-by-week onboarding plan for a new billing hire, beginning with office orientation, computer, phone and email set up before day one, and read-only practice management and EHR access until training finishes. Includes manager and employee sign-off fields.

Charge Capture Checklist

Recording every service performed so it can be billed: confirm the appointment and visit type the day before, verify the provider seeing the patient matches the provider on the claim, and pull insurance details before the visit starts.

Insurance Verification Checklist

Verification to run 24–48 hours before an appointment: legal name and date of birth matched to the card, copies of both sides of the card kept on file and refreshed each visit, member ID, and group number.

EHR Transition Billing Checklist

Phased steps for switching systems without a gap in cash flow, starting 60–90 days out: assign a billing project lead, audit every open and pending claim, and close all open encounters and unsigned notes before migration.

Medicare Annual Wellness Checklist

Documentation and coding for the Annual Wellness Visit, which Medicare Part B covers with no deductible or copay. Explains which code applies, including G0402 for the Welcome to Medicare visit, and when a separate E/M may be billed the same day with modifier 25.

These checklists are general educational resources. Adapt them to your own payer contracts, practice workflows, and the requirements that apply to you.