Running a medical practice is a delicate balancing act. Between patient care, staffing, compliance, and day-to-day operations, billing often becomes the part everyone hopes is “running fine.” But hope isn’t a strategy, especially when your bottom line depends on precision. That’s exactly why performing a revenue cycle audit or medical practice review is so important. It helps you see what’s working, what’s leaking, and how to make every dollar you’ve earned actually reach your account.
That’s where a revenue cycle audit comes in. Think of it as a 90-day health check for your financial system. It reveals where money slips through the cracks, highlights inefficiencies in your workflow, and helps you build a stronger foundation for sustainable growth.
At Concierge Practice Solutions (CPS), we’ve seen firsthand how small billing errors and overlooked denials can quietly drain thousands of dollars each quarter. The good news? A well-structured 90-day RCM audit can identify those leaks and fix them, without overwhelming your team.
Let’s break down exactly how to do it.
Most practices don’t intentionally neglect their revenue cycle; they underestimate its complexity. Between changing payer rules, rising patient responsibility, and the ever-shifting world of coding and documentation, it’s easy for hidden problems to pile up.
Here’s what an RCM audit really does:
An audit isn’t about assigning blame; it’s about creating clarity. By following a structured 90-day plan, you can go from confusion to control — and you don’t have to overhaul your entire system to do it.
The first month is about understanding where your practice stands today. You can’t fix what you can’t measure, so this phase is all about pulling the right data and observing how your current billing process works in real time.
Start here:
Red flags to look for include inconsistent coding, missing documentation, and claims sitting too long in accounts receivable. Even small inconsistencies — like mismatched patient demographics — can cause cascading issues.
At CPS, our physician-owned model brings clinical insight into this process. We understand how a single missed modifier or late documentation entry can affect reimbursement. This clinical-billing connection often reveals issues that traditional billing companies overlook.
Now that you have data, it’s time to find the story hiding inside it. The second month is where the real insight begins.
Step 1: Categorize your denials.
Group them by type and payer. Are you seeing repeat issues for coding, documentation, or prior authorizations? A pattern usually points to a system problem, not a one-time error.
Step 2: Measure your first-pass claim acceptance rate.
Ideally, at least ninety-five percent of your claims should get accepted on the first try. If you’re far below that, it’s time to dig into why.
Step 3: Look at patient collections.
How much of your outstanding balance is patient responsibility? If you see growing balances or frequent write-offs, you may have communication issues at the front desk or outdated billing policies.
Step 4: Map your workflow.
Draw a simple flowchart from patient check-in to payment posting. Where do handoffs happen? Where do delays occur? Every gap is a potential leak.
This is where you’ll start building your Revenue Leak Map — a list of every inefficiency, error, or recurring issue that costs your practice money. It might sound tedious, but it’s eye-opening.
When CPS conducts a medical practice billing audit, this phase is the turning point. We often uncover long-standing issues such as outdated payer contracts, inconsistent coding practices, or insufficient follow-up on denied claims. Identifying them early makes the next phase far more effective.
Now comes the most rewarding part — turning your insights into action.
In this final phase of your 90-day RCM audit, focus on three to five key improvements that will yield the biggest impact.
1. Fix the quick wins first.
Automate eligibility verification. Establish a daily claim review checklist. Tighten charge capture protocols. These small tweaks can immediately reduce errors.
2. Retrain staff where needed.
If your denial analysis shows repeated documentation issues, bring your clinical team and billers together for a refresher session. Clarity across departments prevents repeated mistakes.
3. Prioritize persistent payers.
If one payer repeatedly delays payments, review the contract or renegotiate. Sometimes, a simple update to contact protocols or resubmission timing can improve cash flow.
4. Build a tracking dashboard.
Monitor metrics like:
When you can see these metrics weekly, your team stays aligned and proactive.
At Concierge Practice Solutions, we extend this phase beyond the 90 days through continuous monitoring. Our transparent reporting keeps every client aware of their real-time revenue health — no guesswork, no surprises.
Completing your 90-day audit is an accomplishment, but it’s just the beginning. Revenue cycles are living systems; they evolve as payers change requirements and your practice grows.
To keep things running smoothly:
The more consistent your monitoring, the less likely you’ll face sudden cash-flow crises. Many practices choose to partner with a billing service like CPS because we build that ongoing audit mindset into our process. Every claim, every payer follow-up, every report is part of a continuous improvement loop.
If you’re unsure whether it’s time to audit your revenue cycle, watch for these warning signs:
If any of these sound familiar, you’re overdue for a structured review. A focused medical practice billing audit guide like this can help you get started before the leaks grow larger.
It’s easy to assume that a billing partner or EHR system handles everything behind the scenes. But at the end of the day, your revenue cycle is only as strong as its weakest link — whether that’s documentation, coding, communication, or oversight.
Performing a revenue cycle audit isn’t just about revenue recovery. It’s about reclaiming visibility and control. It gives physicians confidence that their hard work translates into financial stability.
And that’s exactly what we believe at Concierge Practice Solutions. As a physician-owned company, we don’t just process claims — we understand the clinical decisions behind them. That’s how we help practices recover missed revenue, reduce denials, and maintain a transparent, compliant workflow that grows with them.
Your 90-day audit is more than a financial exercise; it’s a roadmap to a healthier, more resilient practice. By dedicating just three months to structured review, you can uncover revenue you didn’t realize you were losing — and strengthen your operations for the long term.
If you’re ready to get started but prefer a guided approach, reach out to Concierge Practice Solutions. Our physician-led billing experts specialize in finding and fixing the inefficiencies most practices overlook. With the right partner, your revenue cycle can work just as efficiently as you do.
