For Medical Groups
Your billing operation may be working. That doesn’t mean you’re collecting everything you earned.
Internal teams and vendors excel at processing volume. RevIQ exists to find, fix, and recover the complex financial exceptions that slip through the cracks of standard workflows.
Request Revenue ReviewWe look where traditional billing processes do not.
Medical groups often sense a disconnect between clinical volume and collected cash, but lack the bandwidth to investigate. Claims are marked as paid, but are they paid correctly? Denials are worked, but is the root cause resolved?
Our engagement is structured to identify the exact source of revenue leakage, recover the funds, and ensure the problem stops occurring. We do not replace your billing operation; we audit and augment it.
7 points of revenue leakage.
To diagnose where a medical group is losing money, we analyze seven specific financial dimensions across your historical billing data. This analysis forms the foundation of the recovery project.
Start the Review Process1. AR Aging Composition
Identifying where claims are stalling and which payer categories are driving the highest aging.
2. Denial Trends & Root Causes
Isolating denials to specific codes, modifiers, providers, or front-end workflows.
3. Payer Trends & Behaviors
Spotting systemic delays in adjudication or patterns of denying valid claims by specific payers.
4. Underpayments
Comparing actual reimbursement against contracted rates to catch silent underpayments.
5. Adjustments
Ensuring inappropriate adjustments are not being made to clear unworked or errored claims.
6. Write-offs
Reviewing standard contractual adjustments for masked, avoidable write-offs.
7. High-Dollar Unresolved Claims
Targeting individual, high-yield accounts that offer the highest immediate recovery ROI.
The Engagement Journey
A structured approach to finding and fixing revenue leakage.
Stage 1
Revenue Leakage Review
We safely ingest your historical billing data to diagnose root causes of poor financial performance, presenting an executive readout of your exposure.
Stage 2
Recovery Execution
Armed with intelligence, our project team deploys to capture the identified opportunity. We execute appeals and resolve targeted AR to bring cash in the door.
Stage 3
Revenue Assurance
We help implement controls and workflow corrections to ensure the identified leakage does not recur, protecting your margins over the long term.
Outcomes & Guarantees
We provide deep intelligence and aggressive execution, but we do not guarantee exact collection amounts. Revenue recovery is heavily dependent on payer rules, timely filing windows, and the quality of original clinical documentation. Our commitment is to correctly identify the leakage and execute every viable avenue for recovery.
Ideal Fit: Independent medical groups, specialty practices, and consolidated clinics generating significant volume, looking for financial clarity and targeted recovery beyond their standard billing operations.
Frequently Asked Questions
Do we need to switch our billing team or EHR?
No. We are not replacing your billing operations. We audit what they leave behind and act as a specialized overlay, working within your existing PM/EHR environment.
What data do you need for a review?
The Revenue Leakage Review requires a secure extract of historical claim data, AR aging reports, and remittance data. We provide clear, secure protocols for transferring this information safely.
How is the recovery phase priced?
Pricing for the execution phase is determined after the Revenue Leakage Review. It is typically structured as a scoped project fee based on the volume and complexity of the identified recovery opportunity.
Is there a guarantee on recovered funds?
No. We identify potential recovery opportunities, but actual collections depend on payer rules, filing limits, and supporting documentation. We agree on the scope of recovery work and report progress, outstanding barriers, and recommended next steps.
Stop guessing about your revenue leakage.
It starts with a review. Let us analyze your data and show you exactly where your billing operation is leaving money behind.
Request Revenue Review