Account Auditing & Consultation Services

What an Afiablee 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.

Reporting You Can Share With Leadership

Every audit ends in a written report and a live readout with practice owners, CFOs or hospital revenue committees. The report is structured around recoverable dollars, recurrence prevention and the specific workflow changes required — not jargon-dense findings that require translation.