RevIQ Health

The 6-Status Lifecycle

Explore how a claim moves through the revenue cycle, where routine workflows can break down, and how independent analysis may surface potential leakage.

EVV is included only when required by the payer, program, or service.

RevIQ
Stage 1 of 6

Authorized

Pre-Service Clearance

What Should Happen

The service is clinically approved, financially cleared, and formally authorized by the payer for a specific date range and unit count.

Where It Fails

  • Services provided before authorization is active or after it expires.
  • Units delivered exceed the authorized limit.
  • Authorization is obtained but for the wrong billing code or modifier.
  • Payer retroactively revokes or updates the authorization without notifying the clinical team.

The RevIQ Approach

We compare authorization data with delivered and billed units to surface discrepancies early. The analysis helps leadership identify recurring clearance gaps and target the workflows creating avoidable leakage.

Stage 1 of 6: Authorized.