AR over 90 days had reached 28% of total AR. The outgoing vendor reported collections but not unbilled encounters, rejections or denial causes. The group needed facts before deciding what to do next.
Ninety days of appointments, encounters, claims and remittances were reconciled. The audit found unbilled encounters, unworked clearinghouse rejections close to timely filing, and a systematic underpayment from one payer using an outdated fee schedule.
- Findings separated into practice actions and billing-team actions
- Appendix lists handed to the practice for immediate follow-up
- Audit findings became the onboarding plan for the new billing scope