Account Auditing & Consultation
Account Auditing & Consultation Services
Most revenue leakage is invisible from inside the practice — it hides in modifier patterns, unworked low-dollar AR buckets, silent payer underpayments and write-off categories that no one revisits. Our auditing and consultation engagements quantify that leakage and hand you a prioritized remediation plan you can act on.
What an Afiable Solutions Audit Covers
Each audit is scoped to the practice's payer mix, specialty and current pain points. We work from your live data — claim files, ERAs, EOBs, AR aging, denial logs and posting variances — rather than from generic checklists.
- Coding accuracy audit across a representative claim sample (CPT, ICD-10, modifier usage)
- Billing workflow audit — eligibility, charge capture, scrubbing, submission and posting
- AR aging deep-dive by payer, bucket and dollar value with leakage quantification
- Denial trend analysis with CARC/RARC root-cause categorization
- Payer underpayment review against contracted fee schedules
- Write-off and adjustment review to surface revenue treated as uncollectible
Common Audit Findings
Across the audits we run, the same patterns repeat — and most are fixable inside 60–90 days once they are visible. Audits don't just produce a report; they produce a list of corrections ranked by recoverable dollars per hour of effort.
- Low-dollar claims aging past timely filing because no one works them
- Underpayments accepted as adjustments rather than disputed
- Modifier patterns generating recurring CO-11 / CO-16 denials
- Eligibility script gaps producing CO-27 denials at the front desk
- Credentialing lapses billing under non-par status without anyone noticing
- Write-off categories used to hide unresolved denials
Consultation Engagement Model
After the audit, our consultants work directly with practice leadership to translate findings into operational change — SOP updates, coder education, front-desk script changes, payer contract renegotiation talking points and KPI dashboards leadership can actually review monthly. We can also remain on retainer for ongoing advisory or transition into a managed RCM engagement if that fits better.
Measurable Outcomes Our Clients Track
Quantified revenue leakage by category
Prioritized remediation plan with owners and timelines
Recovered underpayments and disputed adjustments
Reduced recurring denial categories
Documented SOP and workflow corrections
A written report you can share with leadership
Care Settings We Deliver This For
This service is delivered with workflows tuned to each care setting's payer rules and documentation requirements.
- Physician Practices Account Auditing & Consultation Services
- Multi-Specialty Clinics Account Auditing & Consultation Services
- Hospital Account Auditing & Consultation Services
- Behavioral Health Providers Account Auditing & Consultation Services
- Home Health Agencies Account Auditing & Consultation Services
- Skilled Nursing Facilities Account Auditing & Consultation Services
- Urgent Care Centers Account Auditing & Consultation Services
Discuss Your Revenue Cycle Goals
Speak with our team about how account auditing & consultation services can be structured around your specialty, payer mix and current performance benchmarks.