Find out what your billing is leaving uncollected
Send 90 days of claims data. You get a written review of your denials, aging AR and missed authorizations, with dollar amounts attached. It's free, and you keep the findings whether or not you hire us.
- We reply within one business day to confirm scope and send the BAA.
- You export 90 days of claims, remittance and AR aging. We send the steps for your EHR.
- Written findings with dollar amounts in 5 business days, yours to keep either way.
Every finding comes with a dollar figure
So you know which problem to fix first, whoever ends up fixing it.
| Finding | Detail | Recoverable |
|---|---|---|
| Denials never appealed | 41 claims · top reason CO-197 | $38,200 |
| AR near timely filing | Commercial and MA | $21,650 |
| Sessions past the visit limit | Outpatient therapy · 38 sessions | $5,320 |
| Days outside authorization | Residential · 7 bed days | $9,080 |
| Telehealth coding denials | Missing modifier 95 · 52 claims | $6,980 |
| Total | $81,230 |
What the audit reviews
Six areas, across commercial, Medicare and Medicaid claims. What we look for in each, and what you get back.
Denials
Denial rate by payer, top reason codes, denials never appealed
Dollar value of recoverable denials and the root cause behind each pattern
Aging AR
Claims over 60, 90 and 120 days by payer
What's still collectible before timely filing closes
Authorizations
Outpatient sessions past visit limits, residential days outside authorization windows, missed concurrent reviews
Revenue lost to authorization gaps and where the process broke
Underpayments
Paid amounts versus contracted or expected rates
Short paid claims worth appealing
Coding by level of care
CPT and H codes, revenue codes, units, telehealth modifiers and place of service against documentation
Coding patterns that trigger denials or audit risk
Eligibility
Claims sent to the wrong payer or to terminated coverage
Front end fixes for admissions and intake
How it works
Five steps from the form to the findings.
Request the audit
Fill out the form. We reply within one business day.
Intake call and BAA
A 20 minute call to understand your programs and payers, then a business associate agreement with Part 2 terms.
Secure data export
You send 90 days of claims, remittance and aging reports through a secure transfer. We send exact export steps for your EHR.
Written findings
You receive a written report within 5 business days of receiving complete data.
Review call
We walk through the findings and, if it fits, your pricing tier and a transition plan.
Who the audit is for
If your program is not on this list and you bill insurance, the audit still applies.
- Detox, residential, PHP and IOP programs billing commercial insurance, Medicare and Medicaid
- Outpatient substance abuse and mental health clinics
- MAT and OTP programs
- Private practices and group practices billing insurance
- Programs using an outside billing company that want an independent look
- Programs billing in house that have lost a biller or seen denials rise
What the audit isn't
Three things it is not, so the findings can be taken at face value.
Audit questions
Cost, data and what happens next.
Is the billing audit really free?
Yes. There's no charge and no obligation to sign a billing agreement.
What data do you need?
Ninety days of claims, remittance (ERA or EOB) and AR aging reports. We send export steps for your EHR after the business associate agreement is signed.
How do you protect patient information?
Data is exchanged only after a business associate agreement with 42 CFR Part 2 terms is in place, through a secure transfer, and access is limited to the staff performing the audit.
How long does it take?
Findings are delivered within 5 business days of receiving complete data.
What if we already use a billing company?
That's common. The audit gives you an independent view of how your current billing is performing, and you decide what to do with it.
Do we have to switch if the audit finds problems?
No. Some programs use the findings to fix their in house process. If you'd like us to take over, the transition takes 7 to 14 days.