ClaimCarePro

Free checklist

The Billing Leak Checklist

Twelve points — the version we run before a billing review call. You can work through it in about 30 minutes without knowing a single CPT code.

It opens with a copy-and-paste email you can send your biller in two minutes. Everything after that reads faster once the answers are on your desk.

Nothing in the checklist requires you to hire anyone. A bad number is a question, not a firing — and plenty of good billers will have one.

One field. No credit card, no phone number, no sales sequence. You get the PDF on the next screen whether or not the email reaches you.

Part one: the four numbers

Ask your biller for these four things. The checklist tells you what good looks like, and the trap hiding behind each one.

1

Days in A/R, practice-wide

How long your money sits somewhere that is not your account. Under about 40 days is generally considered healthy — and the checklist shows you the write-off trick that makes this number lie.

2

Percent of A/R over 90 days

One number is an average. Two numbers is a story. This is how you tell a clean average from a good pile and a rotting pile added together.

3

First-pass acceptance rate

Out of every hundred claims you send, how many get paid without anybody touching them again — plus the acceptance-versus-adjudication misread that makes this number look twenty points better than it is.

4

Denial log, by reason code, with a rework column

Industry estimates put roughly 10% of claims denied on first submission and around 60% of those never reworked, at $25+ each to rework. No rework column means no rework process.

Part two: the eight leaks those four numbers hide

None of these show up on an aging report. In practice, this is where most of the recoverable money sits.

  • The adjustment and write-off log — who is authorized, and above what threshold
  • Credit balances and unapplied cash sitting unposted
  • Underpayments against your contracted rate (paid in full, still short)
  • Timely filing losses, by payer, over 12 months
  • Eligibility verification at the front desk, cross-referenced to your denial codes
  • Charge capture — visits seen versus claims actually filed
  • Patient balance follow-up, separated from insurance A/R
  • Provider enrollment and credentialing status, as a grid

Would you rather someone read the numbers with you?

That is a 20-minute call. We will tell you if your billing looks fine — it often does. If you want to keep reading first, the honest cost comparison between keeping billing in-house and outsourcing it is written out here, and there is a calculator for what your denials are costing.

Book the 20-minute call

Benchmarks referenced here — roughly 10% of claims denied on first submission, roughly 60% of denials never reworked, $25+ per rework, healthy days in A/R under about 40 — are industry estimates. They vary by specialty and payer mix and are not predictions about your practice. Our own results, for comparison only: approximately 90%+ first-pass clean claim rate on established accounts, and approximately 70% net collection across 2,000+ claims. Our team brings 30+ years combined experience in medical billing and revenue cycle management.