Services
Audit
A clear, confidential look at what's being missed across your revenue cycle, and how to fix it.
Audit
An audit stands on its own, and the findings are yours either way
Most practices can't see where revenue is slipping until someone looks claim by claim. An audit tells you where it is before you decide anything else.
What's Included
- Claim and coding review
- Denial pattern analysis
- Underpayment analysis against your contracts
- Compliance check
- A plain-language findings report
Who does what
What We Do, And What We'll Ask Of You
Looking across your claims
- What software does
- Scans a larger set of claims and payments for patterns than a manual sample could cover.
- What a person does
- Our specialists check every pattern against the claim and write up the findings.
- What we need from you
- A signed BAA, then an export of claims, payments and denials for the agreed period.
Telling you what it means
- What a person does
- We walk you through the report and what we would fix first.
- What we need from you
- Your payer contracts, so payments can be checked against them.
SampleSampleFindings tableFictional example for illustration. Not a real client, patient, payer or result.
See what a findings report looks like
| Finding | Estimated effect | How we calculated it | Status |
|---|---|---|---|
| One plan pays office visits under contract | $18,400 a year | 2,300 visits × $8 average shortfall | Confirmed |
| Denied authorizations never appealed | $9,280 | 64 denials × $145 average. Some may be past filing limits | Likely |
| Possible overpayments to return | −$2,100 | 14 duplicate payments found. You may owe this back | Confirmed |
| Modifier use on injection visits | Not sized | Sample too small to estimate. Needs a wider review | Unknown |
The number we watch: Revenue at risk. The estimated dollars tied to the problems an audit finds, with how each figure was calculated.
Frequently asked questions
Got Any Questions?
No. An audit stands on its own, and the findings are yours either way.
Yes. We sign a Business Associate Agreement before seeing any patient information.