MEDICAL BILLING AUDIT & PRACTICE OPTIMIZATION

Find the Gaps Affecting Your Revenue and Fix What Matters Most.

Revenue cycle challenges are not always obvious. Lost revenue can result from recurring denials, aging accounts receivable, underpayments, coding inconsistencies, missed charges, inefficient workflows, and gaps between front-office and billing processes.

Maverick helps healthcare organizations evaluate their billing operations, identify areas that may be affecting financial performance, and develop practical strategies for improving the processes behind their revenue cycle.

INTRODUCTION

Better Performance Starts With Better Visibility

Many healthcare organizations know that their billing performance could be stronger but do not have a clear view of where the problems begin.

A billing audit provides an opportunity to examine the revenue cycle more closely and identify the processes, patterns, and operational gaps that may be contributing to delayed reimbursement or unnecessary administrative work.

Maverick reviews the relevant areas of your billing and operational workflow to help identify opportunities for improvement and provide a clearer understanding of where attention may be required.

WHAT WE REVIEW

A Closer Look at the Areas Affecting Your Revenue Cycle

Depending on the scope of the engagement, our assessment may include:

Claims Performance

Review claim submission activity, outstanding claims, rejections, and patterns that may be affecting claim processing.

Denial Trends

Identify recurring denial reasons and review the processes contributing to preventable denials.

Accounts Receivable

Evaluate aging balances, outstanding claims, follow-up activity, and potential recovery opportunities.

Payment Posting

Review payment posting processes, adjustments, and areas where discrepancies may require further attention.

Coding and Charge Processes

Assess available coding and charge workflows for potential inconsistencies or areas requiring review.

Underpayment Opportunities

Review reimbursement activity to identify payments that may require additional investigation.

Front-End Processes

Evaluate eligibility, benefits, authorization, registration, and information workflows that may affect downstream billing.

Payer Performance

Review payer-related patterns that may be contributing to reimbursement delays or operational challenges.

IDENTIFYING REVENUE LEAKAGE

Revenue Loss Is Not Always Easy to See

Revenue leakage can occur across multiple stages of the healthcare revenue cycle.

A claim may never be submitted because of a charge capture issue. A denial may remain unresolved because follow-up was delayed. An underpayment may go unnoticed. Patient information may require correction after services have already been provided.

Our audit process helps organizations gain greater visibility into the areas where revenue may be delayed, overlooked, or affected by inefficient processes.

Common Areas of Review

Unresolved Claim Denials
Aging Accounts Receivable
Delayed Claim Submission
Claim Rejections
Missed Charges
Coding Inconsistencies
Incomplete Patient Information
Eligibility Issues
Authorization Gaps
Underpayments
Delayed Payment Posting
Limited Reporting Visibility

OUR AUDIT PROCESS

A Structured Approach to Understanding the Problem

Discovery

We begin by understanding your organization, services, specialty, systems, workflows, and the challenges you want to address.

Data and Process Review

Relevant billing activity, available reports, and operational workflows are reviewed based on the agreed scope of the assessment.

Identify Patterns

We look for recurring issues, trends, workflow gaps, and areas that may be affecting revenue cycle performance.

Prioritize Opportunities

Findings are organized based on their potential impact and the level of attention they may require.

Recommendations

We provide practical recommendations focused on improving processes and addressing the identified areas.

Optimization Support

Where applicable, Maverick can provide ongoing support to help implement improvements and monitor relevant processes.

PRACTICE OPTIMIZATION

Improving More Than Your Billing Process

Practice performance is influenced by the way different teams and processes work together.
Front-office activities affect billing. Billing performance affects accounts receivable. Provider documentation affects coding. Payer requirements affect the entire reimbursement process. Practice optimization takes a broader view by examining the connection between operational workflows and financial performance.

Maverick helps healthcare organizations identify opportunities to improve areas such as:

Workflow Efficiency

Review processes to identify unnecessary steps, delays, or inconsistencies.

Responsibility and Communication

Create clearer workflows between front-office, clinical, billing, and administrative teams.

Revenue Cycle Coordination

Improve how information moves between different stages of the patient and billing journey.

Operational Visibility

Develop greater awareness of the metrics and processes affecting performance.

Process Standardization

Establish more consistent workflows where variation may be creating unnecessary challenges.

WHAT YOU CAN GAIN FROM AN AUDIT

A Clearer View of What Needs Attention

The purpose of a billing audit is not simply to identify problems. It is to provide useful information that can support better decisions.

A structured assessment can help healthcare organizations gain:

Greater Visibility

Understand where challenges are occurring across the billing process.

Clearer Priorities

Identify which issues may require immediate attention and which can be addressed over time.

Practical Recommendations

Receive recommendations based on the findings and the requirements of your organization.

Improved Workflow Awareness

Understand how operational processes may be affecting financial performance.

Opportunities for Improvement

Identify areas where stronger processes, follow-up, or coordination may support better outcomes.

FROM FINDINGS TO IMPROVEMENT

An Audit Is the Beginning, Not the End

Identifying a problem is valuable, but meaningful improvement requires action.

After an assessment, Maverick can support healthcare organizations in addressing the areas identified through the audit. Depending on the organization’s needs, this may include strengthening billing workflows, improving denial management, prioritizing A/R, reviewing front-end processes, or providing ongoing revenue cycle support.

This creates a practical path from identifying challenges to implementing improvements.

WHY MAVERICK

An Independent Perspective on Your Revenue Cycle

An internal team may be highly familiar with its daily processes, which can sometimes make recurring challenges difficult to identify.
Maverick brings an outside perspective while taking the time to understand how your organization operates.

Our approach focuses on:

Looking Beyond Individual Errors

We examine recurring patterns and the processes contributing to them.

Connecting Operations and Revenue

We consider how front-end, billing, coding, payer, and follow-up processes affect one another.

Prioritizing What Matters

Not every issue requires the same level of attention. We focus on identifying opportunities based on their relevance and potential impact.

Providing Practical Direction

Our recommendations are designed to be relevant to your organization’s operational realities rather than generic suggestions.

GET STARTED TODAY

Discover Where Your Revenue Cycle Can Improve

If you are experiencing persistent denials, growing accounts receivable, delayed reimbursement, limited billing visibility, or operational challenges, a structured review can help you better understand where attention is needed.

Maverick can help you evaluate your billing operations, identify potential opportunities for improvement, and develop a clearer path forward.