This document is designed to systematically present the elements that must be addressed to enable effective revenue generating operations at local health departments (LHDs) providing immunizations. This information is intended primarily for immunization services, however much of it is applicable to billing for a range of services. The business requirements referred to are recommendations for effective practice. There is no single solution for many of the elements of the billing cycle, thus guidance and recommendations are given as opposed to a strict blueprint of a perfect billing system. The variability between LHDs ensures that there is nosingle approach that will work for all LHDs. The document is organized to first review the processes involved in generating revenue for individual claims; the revenue cycle. The second section of the document details billing foundation elements that must be in place to support the revenue cycle processes. The business requirements must be considered in their entirety because so many factors are interrelated.