Know which numbers are moving, and why.
Most practices have data. Very few have answers. A monthly collections figure tells you what happened. It won't tell you whether your clean claims ratio slipped, which payer is underpaying, or which provider's E/M distribution is quietly costing you revenue.
Practice health check
Measuring against your benchmark
- Clean claims ratio
- Days in A/R
- Net collection rate
- Denial rate by payer
- A/R aging distribution
- Cost to collect
Root cause over reporting
A rising denial rate is a symptom.
Identifying that denials rose is the easy part. We identify which payer, which code family, and which upstream step.
The symptom
Your denial rate is rising.
Narrow it
Which payer?
Narrow it
Which code family?
Find the source
Which upstream step?
The answer
A specific fix, assigned, with its estimated revenue impact.
What we analyze
Six places revenue quietly leaks.
Revenue cycle KPIs
The metrics that actually predict financial health, each measured against a defined target.
What we check
- Clean claims ratio
- Days in A/R (30–35 day target)
- Net collection rate
- Denial rate by payer & root cause
- A/R aging distribution
- Cost to collect
Our process
Monitored, not sampled once.
Step 6 runs on repeat
- 01
Data collection
Front-office records, billing and coding data, remittances, payer contracts and fee schedules.
- 02
Benchmark selection
Targets set for your specialty, practice size and payer mix. No generic industry averages.
- 03
Analysis
Statistical review of KPIs, denial patterns, coding distribution and A/R composition.
- 04
Root cause
Separating symptoms from causes.
- 05
Recommendations
Specific, sequenced and assigned, tied to estimated revenue impact where possible.
Ongoing tracking
Recurring reporting that shows whether the changes moved the metric.
What you receive
Findings you can plan, budget and verify against.
- 01Performance reportSection 1
Current-state metrics with benchmark comparison and variance flagged.
- 02Gap analysisSection 2
Where performance is deviating and what's causing it.
- 03Prioritized recommendationsSection 3
Ranked by revenue impact and implementation effort.
- 04Financial forecast inputsSection 4
Data you can actually plan and budget against.
- 05Compliance findingsSection 5
Coding, documentation and payer requirement gaps.
- 06Follow-up reportingSection 6
Verification that implemented changes moved the metric.
Specialties we support
Scoped to how your specialty actually bills and collects.
Internal Medicine
Outpatient volume, E/M distribution, and multi-payer primary care cycles.
Urgent Care
High-throughput claim patterns, same-day documentation, and A/R targets that fit urgent care workflows.
Pain Management
Procedure-heavy coding, authorization-sensitive services, and specialty-specific denial and productivity patterns.
Why Torix Health
Benchmarks, root cause, and a way to act on them.
- 01
Operating experience
Analysts and consultants who have run revenue cycles, not general-purpose data staff.
- 02
Benchmarks, not just numbers
A metric without a comparison point isn't information. Every KPI is reported against a defined target.
- 03
Recommendations tied to dollars
Each finding carries an estimated revenue impact, so you can sequence by return.
- 04
HIPAA compliant throughout
All PHI and financial data handled under documented safeguards.
- 05
Connected to execution
Torix also runs revenue cycle management, billing and credentialing, so findings can be implemented rather than just delivered.
FAQ
Frequently asked questions
Not seeing your question? A billing specialist will answer it directly, not a ticket queue.
Ask us directly01How is performance analysis different from a billing audit?
An audit tests a sample of claims for accuracy and compliance. It answers "were these coded and billed correctly?" Performance analysis is broader and forward-looking: it measures the whole revenue cycle against benchmarks to answer "where is this practice losing money, and what should change?" Audits often feed into it.
02What data do you need from us?
Front-office and registration records, billing and coding data, remittance and payment data, payer contracts, and fee schedules. We'll provide a specific list scoped to your systems.
03How often should performance be reviewed?
Monthly for core KPIs, quarterly for deeper analysis. Annual review is too infrequent to catch a trend while it's still cheap to correct.
04What benchmarks do you compare against?
Specialty-specific and practice-size-adjusted benchmarks rather than blanket industry averages. A 40-day AR figure means something different in a surgical practice than in urgent care.
05Can you analyze performance if our billing is handled in-house or by another vendor?
Yes. Analysis is independent of who runs the billing. The findings are yours regardless.
06Do you provide reporting on an ongoing basis or as a one-time engagement?
Both. Some practices need a one-time assessment; others prefer recurring KPI and follow-up reporting. We'll confirm scope and cadence during the assessment conversation.
07How quickly do we see results?
Front-end fixes (eligibility verification, registration accuracy, authorization capture) typically show up within a billing cycle. Coding and contract changes take longer to flow through.
08What is included in a medical billing audit?
A billing audit can review claims, coding, documentation, payments, denials, payer reimbursements, and other revenue cycle processes to identify errors, compliance concerns, and missed revenue opportunities.
09How can a billing audit help my practice?
An audit can help identify recurring billing errors, underpayments, missed charges, incorrect coding, avoidable denials, and process inefficiencies that may be affecting your revenue.
10How often should a medical practice conduct a billing audit?
The ideal frequency depends on the size and complexity of the practice. Regular audits can help identify problems early and ensure billing processes remain accurate, efficient, and compliant.
Next step
Get started with a performance assessment.
If you can't currently state your clean claims ratio, your denial rate by root cause, and your days in AR, you're managing the practice's finances on a lagging indicator. Send us your specialty, practice size, and payer mix and we'll scope an analysis.