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Preview the Guide

See exactly what a Revenue Cycle Health Check uncovers — the five leakage areas and the process we use to find them — before you request yours.

REVENUE CYCLE HEALTH CHECK · PREVIEW
GUIDE

Find the Leakage. Fix the Process.

5
Leakage areas
7
Step process
1
Structured audit
What's inside.
Front-End Leakage02
Clinical-to-Billing Leakage04
Claims Leakage06
AR Leakage08
Process Leakage10
The 7-Step Engagement Model12
AUDIT
FIRST
CHAPTER 03 · CLAIMS LEAKAGE
5 — AREAS, 1 — AUDIT

Where claims
quietly die.

Rejections, denials, filing issues and payer-specific problems stall reimbursement long after the visit is over. Most practices never see the pattern — only the backlog.

Every leakage area follows the same path from discovery to a fixed process. Claims Leakage is where it becomes most visible — a rejected claim is a symptom, not the problem. The real question is always the same: what upstream process let it happen, and will it happen again next week?

01Discover. Understand your practice, specialty and payer mix.
02Audit. Identify revenue leakage across all five areas.
03Analyze. Determine root causes and prioritize by impact.
04Optimize. Redesign the processes that are actually broken.
“

Don't just manage the billing. Understand the revenue.

— Blue Bird Medserv
Get StartedRequest your free Revenue Cycle Health Check — see your practice's five leakage areas mapped out.
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What the Revenue Cycle Health Check Is, and What It Is Not

The Health Check is a structured first look at where a practice's revenue cycle leaks. It maps findings across the five leakage areas shown above: front-end, clinical-to-billing, claims, AR and process. It is a diagnostic, not a billing takeover and not a sales presentation. Its purpose is to answer four questions for each leak: what is wrong, why it is happening, where money is being lost, and what should be fixed first.

It does not replace a deeper financial review. The Practice Revenue Cycle Audit goes further into scorecard, trend, benchmark, denial and write-off data, and the RCM Audit describes the full independent assessment and its report.

The Seven Steps in Practice

The guide above shows four of the stages. Here is what a complete engagement involves in practical terms:

  1. Discover. Understand specialty, providers, locations, systems and payer mix. Identify known pain points such as a payer that always pays late.
  2. Collect data. Gather charge, payment, adjustment, AR aging, claim and remittance exports for roughly the last twelve months.
  3. Audit. Test each of the five leakage areas against the data. This includes reconciliation, KPI calculation and a traced sample of encounters and claims.
  4. Analyze. Group findings by upstream cause and attach a dollar value to each. Separate lost, delayed and underpaid revenue.
  5. Prioritize. Rank findings by dollars, time sensitivity, recurrence and effort to fix.
  6. Recommend. Write specific corrective actions with owners, such as an authorization check at scheduling or a daily rejection worklist.
  7. Optimize and monitor. Redesign the broken processes, then re-measure the same KPIs with the same definitions to confirm the change.

What Each Leakage Area Examines

AreaWhat the check examinesTypical data usedRed flag
Front-endEligibility and benefits checks, authorization, patient information accuracy271 responses, authorization log, registration dataCO-27, CO-22, CO-109 and CO-197 denials; unexpected patient balances
Clinical-to-billingCharge capture, coding accuracy, documentation supportSchedule, encounter list, charges, notes sampleEncounters with no charge; E/M level skew; CO-50 denials
ClaimsClean claim rate, rejections, denials, timely filing, payer rules837 files, 999 and 277CA reports, 835 remittancesCO-16, CO-18 and CO-29 patterns; rejection backlog
ARAging, follow-up cadence, underpayments, write-offsAR aging, payment and adjustment detail, fee schedulesGrowing 90+ day share; repeating underpayment on a CPT
ProcessManual work, ownership, handoffs, reportingWorkflow descriptions, staff rolesUnowned work queues; repeated manual checks

Data to Have Ready Before You Request a Health Check

  • Charge, payment and adjustment reports covering about twelve months, by date of service.
  • Current AR aging by payer, with prior month-end snapshots if available.
  • Remittance (835) files or reports that show CARC and RARC codes.
  • Clearinghouse reports showing rejections and acknowledgments.
  • Payer list and any fee schedules or contracts for the top payers.
  • A short list of problems the team already knows about.

You do not need to have everything. Tell us what is available, and the Health Check can start with what your systems export. Sharing protected health information should happen only under a HIPAA Business Associate Agreement and be limited to the minimum necessary.

How to Read Your Results

ResultHealthyNeeds attention
Front-endEligibility run on nearly every visit; few authorization denialsEligibility checked only when a problem is suspected
Clinical-to-billingDaily encounter-to-charge reconciliation; stable E/M mixOpen encounters at month-end; charges entered late
ClaimsRejections worked daily; denials concentrated in non-preventable causesSame preventable denial repeating month after month
ARMost dollars in younger buckets; underpayments checkedDollars drifting into 90+ days; no payer variance check
ProcessEach queue has an owner and a turnaround targetWork depends on individuals; reports built by hand

A Health Check result is a starting map. The findings with the closest filing or appeal deadlines are handled first, and the rest are sequenced by dollars and effort.

An Illustrative Findings Summary

Illustrative only. This is a hypothetical summary, not a client result. Real reports use your data and your dollar figures.

AreaHypothetical findingRoot causePriority
Front-endAuthorization denials cluster on one payerNo check at schedulingHigh
Clinical-to-billingCompleted visits with no chargeEncounter forms not routed to billingMedium
ClaimsRejections aging in the clearinghouse queueNo daily worklist ownerHigh
ARRepeating underpayment on one E/M codeOutdated fee schedule at payer; no variance checkMedium
ProcessClaim status checked manually, one claim at a timeNo automation of status checksLow

Health Check, Practice Audit and RCM Audit: Which One Do You Need?

EngagementBest forFocus
Revenue Cycle Health CheckA first look at where revenue leaksFive leakage areas, root causes, priorities
Practice Revenue Cycle AuditPractices wanting financial depthScorecard, trends, benchmarks, AR, denials, write-offs, appeals, SWOT
RCM AuditA full independent assessment before any vendor decisionEligibility through payment posting, with the Revenue Cycle Health Report

The Health Check is designed as the starting point. The deeper audits are the natural next step when it reveals areas worth quantifying.

Common Root Causes and the Fixes That Usually Work

Across the five areas, the same handful of root causes explain most findings. Knowing them helps you judge whether a Health Check result is a process problem you can fix yourself.

  • Verification happens too late. Eligibility is checked when a claim is denied, not before the visit. The fix is a 270/271 inquiry at scheduling, repeated shortly before the appointment, with the response stored and acted on.
  • Authorization is tracked from memory. Staff remember which payers require it for which procedures. The fix is a written payer-by-CPT matrix with a named owner, reviewed when payer policies change.
  • Charges depend on paper or memory. Encounter forms are not returned, or procedures are not entered. The fix is a daily reconciliation of completed visits against charges and a short charge-lag target.
  • Rejections have no owner. Claims rejected at the clearinghouse (visible in 999 and 277CA reports) sit unworked until they age past the payer's timely filing limit, which commonly runs from 90 days to one year. The fix is a daily rejection worklist.
  • Denials are worked one at a time. Each denial is appealed or corrected, but the cause is never fixed. The fix is categorizing denials by CARC and root cause, then changing the upstream step.
  • Remittances are posted by hand. Slow, error-prone posting delays follow-up and hides underpayments. The fix is 835 auto-posting with an exception queue and a regular comparison of allowed amounts to contract rates.

What Happens After the Health Check

You receive a written summary of findings by area, each with a root cause, a dollar impact, a recommended fix and a priority. Items with closing recovery windows are flagged first. From there the options are open: your team can implement the fixes, you can ask for a deeper Practice Revenue Cycle Audit, or you can discuss Revenue Cycle Optimization or managed services where they make sense. Re-running the same KPIs with the same definitions later shows whether the changes worked.

Frequently Asked Questions

It depends mainly on how quickly your data can be exported. The analysis starts once complete data is available, and a walkthrough conversation reviews the findings with you.

No. Some findings are process fixes your own team can make. The Health Check is designed to tell you what you actually need, which may or may not be a new vendor.

It is offered free of charge as an introduction to the work. You keep the findings whatever you decide to do next.

No. This page is a preview of the Health Check guide. The sections below it add practical detail on method, data and how to read results.