What’s Included (Deliverables)
1. Front-End Revenue Cycle Assessment
We evaluate the systems that determine whether claims are clean before they’re ever billed.
Scheduling accuracy & insurance capture
Eligibility & authorization verification processes
Patient intake workflows
Referral management
Financial policy compliance
Missing/incorrect demographic patterns
2. Mid-Cycle & Clinical Documentation Review
The most overlooked source of lost revenue.
Provider documentation quality
Coding integrity (CPT/ICD-10/modifiers)
Encounter closure timeliness
Surgical/procedural coding accuracy
Charge capture completeness
EMR workflow optimization
3. Billing & Claims Management Audit
We uncover systemic gaps that drive denials.
Clearinghouse performance
Claim submission timelines
Denial rate analysis (by type & payer)
Underpayment identification
IDR opportunities (NSA)
PIP/WC/NF compliance review
4. Accounts Receivable & Collections Analysis
We assess AR by payer, CPT category, and aging bucket.
AR aging review (0–30, 31–60, 61–90, 90+)
Cash acceleration strategy
Root-cause analysis of AR >90 days
Appeal and escalation review
WC/PI outcomes & settlement patterns
5. Staff Competency Evaluation
Your people dictate your revenue. We evaluate:
Billing team proficiency
Front desk compliance
Authorization team accuracy
Documentation habits
Accountability gaps
Training needs & role misalignment
6. Executive-Level Action Plan (30–60–90 Days)
You receive a prioritized roadmap that leadership can use immediately:
Quick wins for immediate revenue lift
Medium-term process fixes
Long-term structural improvements
Performance KPIs and benchmarks
Recommended organizational adjustments
Technology & EMR optimizations
Timeline
3–4 weeks, depending on practice size.
Sample cadence:
Week 1: Intake, data requests, leadership interviews
Week 2: Workflow observation, detailed audit
Week 3: Data analysis, dashboard creation
Week 4: Final report, executive presentation, implementation guidance