Check Out Our RCM Health Check - Get Insights on Your Business

RCM Health Check

Revenue Cycle issues rarely come from one big mistake — they come from small breakdowns across intake, authorizations, billing, and follow-up that add up over time.

This quick RCM Health Check helps you spot where revenue may be leaking and whether your current systems are giving you the decision-ready insight you need to grow. Answer the questions below with Yes / No. It takes about 2 minutes, and your results will point you toward the highest-impact next steps.

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RCM Health Check

Revenue Cycle issues rarely come from one big mistake — they come from small breakdowns across intake, authorizations, billing, and follow-up that add up over time.

This quick RCM Health Check helps you spot where revenue may be leaking and whether your current systems are giving you the decision-ready insight you need to grow. Answer the questions below with Yes / No. It takes about 2 minutes, and your results will point you toward the highest-impact next steps.


Instructions:
Read each statement and decide whether it’s true for your organization.

  • If YES, place a check mark or “1” on the line.

  • If NO, leave it blank.

At the end, count how many YES answers you marked.

Total YES Score: ____ / 21

CATEGORY 1 — Intake & Authorization (Strength)

How well do you protect revenue before services are delivered?

  • We verify benefits as part of intake. _____
  • Prior authorizations are obtained on time (before services are delivered). _____
  • Authorization limits and expiration dates are tracked consistently. _____
  • Intake follows a consistent and documented workflow. _____
  • We rarely deliver care without confirmed eligibility/authorization. _____

CATEGORY 2 — Clean Claims & Billing (Accuracy)

Are you billing correctly and quickly enough to prevent lost revenue?

  • Claims are submitted within 24–72 hours of service delivery. _____

  • Notes are completed no more than 48 hours after services are delivered. _____

  • Documentation meets the criteria for the services that are billed. _____

  • Claims are scrubbed/validated before submission. _____

  • Coding is accurate and updated across all service lines. _____

  • Unbilled encounters are caught and corrected at least weekly. _____

CATEGORY 3 — Payment Posting & A/R (Performance)

How predictable and controlled is your cash flow and follow-up process?

  • Payments are tracked and posted daily (or within 48 hours). _____

  • Denials and rejections are worked consistently using a documented workflow. _____

  • Underpayments and recoupments are tracked and addressed consistently. _____

CATEGORY 4 — Financial Reporting & Visibility (Clarity)

Can leadership trust the numbers enough to make decisions?

  • Monthly close is completed on a consistent timeline. _____

  • Revenue is reconciled across billing reports and bank deposits monthly. _____

  • Leadership reviews KPIs no less than monthly (some KPIs reviewed quarterly). _____

  • Forecasting and/or cash flow planning is updated monthly. _____

  • Dashboards/reporting clearly show payer mix and denial trends. _____

  • We review payor guidelines and contracts no less than annually. _____

CATEGORY 5 — Operational Alignment & Scalability (Systems)

Are your workflows strong enough to grow without breaking?

  • SOPs exist for intake, billing/RCM, and financial close processes. _____

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