Tis’ the season when no yard, flower bed, garage or closet is safe.  The sunshine, warmer weather and longer days seem to get everyone motivated on their spring-cleaning projects. Whether it is decluttering, organizing, completing or starting a new project, the to-do list can get lengthy in no time!  What if we were to step back and look at Billing in the same manner? 

As we have moved into the second quarter of 2026, now is a good time to review any outstanding billing records!  The billing staff, frequency of submission, volume of claims and types of payers vary between our clients and their industries; however, they all have one thing in common…Billing is HARD.  We are hopeful that the ideas and suggestions shared below will provide you with a starting point on your Spring clean and will get your Billing brain engaged so that you are paid for all the services rendered by your staff.

Add these 4 ideas below to your to-do list and see how much progress you make!

1. Reviewing Not Billed Records
   1. detaso has numerous workflows and safeguards in place that ensure records that are billed are complete and accurate.  On occasion, there can been services rendered, but the claim does not meet the criteria for billing.  You should monitor and resolve issues for claims located in the Not Pulled Queues, Not Locked/Signed Queues and On Hold Records.  Confirming that all rendered services have been billed is a great place to start your project!
2. Outstanding Claims Pending Payer Response
   1. As you are aware, each payer responds to submitted claims in different time frames.  It is important to monitor your submitted claims and ensure each payer has responded.  We see most state payers respond within a 7–14-day window, whereas private pay insurances can range into the 30+ day window.  If a response is not provided within a timely manner, that now makes you unaware of the claims status and whether further action is needed.  For detaso users, we have the benefit of ClaimMD being the first contact in helping locate a missing ERA or payer response.  Most payers have their own respective portals that can be utilized as a resource as well.  If a claim is billed, we should expect a response from the payer 100% of the time.
3. Credentialing
   1. Payers have different requirements and lengths of eligibility for both your rendering providers, as well as, your entity, the billing provider.  It is important to be aware of those requirements and the status of specific individuals.  In doing so, you will prevent the possibility of services being rendered that you are unable to collect payment on due to the respective enrollment status with specific payers.  Don’t let an enrollment form or roster update be the reason a claim goes unpaid!
4. Private Pay Invoices 
   1. Once you have confirmed all payer responses have been provided and no additional payments are going to be made by a primary, secondary or tertiary payer, you can then bill any balance that the consumer is responsible for to a private pay invoice.  You would want to run and print your private pay invoices and provide to your consumers or their guardian for payment.  Close the loop on these records to ensure you receive 100% of your expected amount!

As long as care is being provided and services are being rendered, there will always be work to do in the Billing Department.  It is important to evaluate each claim as the individual record it is, take into consideration the information you know and then use your billing knowledge to determine next steps. At detaso, we understand how difficult Billing can be.  We want you to know that we are happy to work alongside you to get your claims submitted successfully and paid in full. Success without integrity is hollow. By refining these processes today, you aren’t just increasing revenue—you are building a foundation of trust for your staff and your patients. Let’s take this season to ensure our operations are the truest, most effective version of themselves.