Revenue Integrity Audit
A revenue integrity audit reviews coding, charge capture and payer payments line by line to find revenue you earned but did not collect, and compliance risks you should fix.
Problems we solve
- Services delivered but never charged
- Payments below contract rates that nobody checked
- Codes that do not match documentation
How it works
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Sample selection
We take a representative sample of paid and denied claims.
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Line-by-line review
Each claim is compared with documentation, coding rules and payer contracts.
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Findings report
Issues are grouped by cause with their financial impact.
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Action plan
You receive prioritised fixes and can ask us to carry them out.
What you will see in reporting
- Missed charges and underpayments
- Coding accuracy
- Recommended fixes in priority order
Who it suits
A good first step before outsourcing, or an annual health check for any practice.
Specialties we support
- Primary Care
- Dental Practices
- Orthopedics
- Cardiology
- Mental Health
- MSOs & DSOs
- Urgent Care
- Dermatology
- Physical Therapy
- Ophthalmology & Optometry
Related guides
How to Reduce Claim Denials: A Practical Guide
Most denials are preventable. A practical guide to fixing registration, coding, authorization and follow-up.
2 min read
Understanding Common Denial Codes (CO-16, CO-45, CO-97)
What group codes and reason codes mean, the denials you will see most, and how to respond to each.
2 min read
Frequently asked questions
How big is the sample?
We agree the size with you based on claim volume and goals.
Will you tell us if coding is too aggressive?
Yes. An audit looks at errors in both directions, because over-coding is a compliance risk too.
Book a free consultation
Tell us about your practice and the support you are looking for. We will arrange your free consultation.