Process
A process built to remove uncertainty
Clinics hire an outsourcing partner to reduce chaos — not add more. This process is designed so you always know what happens next, who owns what, and how progress is measured.
1) Discovery (Day 1–2)
Systems, payer mix, volumes, pain points, KPIs, responsibilities.
Systems, payer mix, volumes, pain points, KPIs, responsibilities.
2) Setup (Day 2–5)
Access plan, role permissions, work queues, templates, SOPs, QA checklist.
Access plan, role permissions, work queues, templates, SOPs, QA checklist.
3) Daily Execution (Week 1+)
Work queues, status updates, turnaround expectations, escalation when blocked.
Work queues, status updates, turnaround expectations, escalation when blocked.
4) QA + Root‑Cause
Sampling checks, denial trend review, fixes applied to prevent repeats.
Sampling checks, denial trend review, fixes applied to prevent repeats.
5) Weekly Reporting
KPIs + blockers + next actions. Monthly trend review for optimization.
KPIs + blockers + next actions. Monthly trend review for optimization.
Weekly report
What you’ll see (decision-ready)
- Volume processed (claims/posting/follow-ups)
- Denials by category + top root causes
- AR movement and priority queues
- Open blockers + escalation items
- Next actions for the week
Onboarding
What we need to start
- Systems used (EHR/PM, clearinghouse)
- Payer list + basic volumes
- Access method (roles or supervised access)
- Your priority KPIs and pain points