Ascentiant Health, an Ascentiant International Company

1341 Distribution Way
Suite 11 - Top Floor
Vista, CA 92081

Revenue Cycle Assessment Checklist

Use this checklist to evaluate your current revenue cycle performance. Check each item your organization has in place and functioning effectively.

• Insurance eligibility verified at scheduling and again at check-in
• Benefits and cost-sharing communicated to patients before service
• Prior authorization requirements identified and obtained before date of service
• Patient demographics, guarantor, and contact information verified at every visit
• Referrals and PCP assignments captured and validated for managed care plans
• Self-pay and financial assistance policies documented and consistently applied
• Point-of-service collections process defined with staff accountability
• Good Faith Estimates provided where required under the No Surprises Act

• Charge capture occurs within 24 hours of date of service
• Medical necessity and documentation support all billed services
• Coding reviewed for accuracy — CPT, ICD-10, and modifiers applied correctly
• Claims scrubbed for edits before submission (NCCI, LCD/NCD, payer-specific rules)
• Clean claim rate tracked and trending reviewed monthly
• Timely filing deadlines monitored by payer with escalation process
• Batch submission and rejection work queues managed daily
• Charge master reviewed and updated at least annually

• Denial rate tracked by category, payer, and root cause
• Preventable denials identified and routed to front-end or coding for correction
• Appeal workflows defined with documentation standards and deadlines
• Denial write-off thresholds and authorization levels documented
• Staff retrained on top denial drivers quarterly
• Payer edit changes monitored and communicated to billing team
• Denial recovery rate measured and reported to leadership

• Days in A/R calculated monthly and benchmarked against specialty norms
• A/R aging reviewed weekly with action plans for 90+ day balances
• Unapplied payments and credit balances resolved within 30 days
• Patient statements sent on a consistent schedule with clear payment options
• Collection agency or bad debt policy defined with compliance safeguards
• Contractual adjustments posted accurately and reconciled to remittance advice
• Stale claims and suspended accounts worked with defined follow-up cadence

• Provider enrollment status verified before claims are submitted to each payer
• CAQH profiles current and attested within required timeframes
• Revalidation and recredentialing deadlines tracked with 90-day advance alerts
• New provider onboarding includes enrollment before first patient visit
• Group and individual NPIs validated against payer rosters
• Contract effective dates confirmed before billing at contracted rates
• Licenses, DEA, and malpractice coverage monitored for expiration

• Key RCM KPIs reported monthly to leadership (net collection rate, denial rate, days in A/R)
• Charge lag, payment lag, and claim submission lag tracked by department
• Payer mix and reimbursement variance analyzed quarterly
• Productivity metrics defined for billing, follow-up, and denial staff
• Dashboard or scorecard accessible to operations and executive team
• Benchmark comparisons used to set improvement targets
• Audit findings tracked to resolution with trend reporting