Definition
This segment of the revenue cycle covers the steps that happen before and at the start of a visit. It includes scheduling, registration, eligibility checks through the 270/271 transaction, prior authorization, and collecting patient balances at check-in. Uninsured and self-pay patients also receive a Good Faith Estimate here.
Why it matters
Many preventable denials start here, with a wrong member ID, inactive coverage, or a missing authorization. These errors take seconds to fix at check-in but weeks to fix after a denial. Front-end gaps also leave patient balances that are harder to collect after the visit.
Example
A front desk scans a new insurance card but skips the eligibility check. The plan ended last month, so the claim denies and the full balance shifts to the patient weeks later.