Stop Guessing. Start Measuring.
Most healthcare administrators do not know their practice's exact clean claim rate, their specific days in Accounts Receivable (AR) by payer class, or how much clinical revenue is being lost to "unspecified" ICD-10 downcoding. By the time the financial reports reveal a cash flow crisis, thousands of dollars have already passed the 90-day timely filing window, becoming permanent bad debt.
Prismatica Health's Free Revenue Cycle Audit provides a crystal-clear, forensic X-ray of your financial health. Our AAPC-certified analysts and RCM architects will review a sample of your recent claims, your ERA (Electronic Remittance Advice) remark codes, and your aging AR buckets to isolate exactly who is withholding your money and why.
What Our Forensic Audit Uncovers
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Hidden Clinical Downcoding
We analyze your physician's E/M bell curves. Are your doctors routinely billing Level 3 visits (99213) for complex coordination of care out of fear of Medicare RAC audits? We identify exactly how much legal revenue you are leaving on the table.
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Root-Cause Denial Mapping
We don't just look at the dollar amount lost; we translate your CO-4, CO-16, and CO-97 denial codes to map the exact failure point. Is the front desk failing to capture accurate eligibility, or is your current billing team misusing Modifier 59 on surgical claims?
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Aging AR Bottlenecks
We profile your accounts receivable exceeding 60, 90, and 120 days. Claims aging past 90 days have less than a 40% chance of ever being collected. We identify which specific commercial carriers are purposely utilizing delay tactics on your high-dollar procedures.
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Pre-Authorization Leakage
We evaluate the frequency of CO-197 (Authorization Absent) denials to determine if your clinical staff is successfully navigating Radiology Benefit Managers (RBMs) or if expensive tests and medications are being delivered for free.
100% Secure & Confidential
Your practice?s data is legally protected. Preliminary audits are conducted entirely under absolute HIPAA compliance and covered by a strict Non-Disclosure Agreement (NDA). You are never under any obligation to hire Prismatica Health after reviewing your audit results.
The Audit Timeline
- Step 1: Submit the secure form to schedule your initial 15-minute discovery call.
- Step 2: Provide secure, read-only access to a minor sample of your practice management reports or recently denied ERAs.
- Step 3: Within 48-72 hours, our analysts construct your customized Executive Summary Report.
- Step 4: We hold a joint strategy session to review the findings, the identified revenue gaps, and the precise tactical steps required to immediately halt the bleeding.