Managed Revenue Intelligence for Procedural Practices

Find the revenue your practice is losing.

Get clear, prioritized actions for denial leakage, underpayments, and cancellation-driven revenue loss, delivered directly to your inbox.

We help procedural practices strengthen revenue integrity by showing where revenue is leaking, why it is happening, what it is worth, and what to fix first. No new software for your team to manage. No dashboard adoption required. Just actionable revenue intelligence from the claims and scheduling data you already have.

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Pain ManagementGastroenterologySpine SurgeryOrthopedicsUrologyOphthalmology

Three revenue leakage questions most practices cannot answer clearly

01Denied Revenue

Which denials are preventable, recurring, and costing us the most?

Most practices know denials are happening. What they cannot easily see is which denial patterns are avoidable, which payers or workflows are driving them, and which fixes would protect the most revenue.

When denial leakage is not quantified by cause and financial impact, teams spend effort on the wrong problems.

See what Prexisio would surface from your data

Prexisio uses your claims and scheduling files to identify, quantify, and prioritize revenue leakage. Your team does not need to adopt another software system to get the answer.

The problem

Revenue is leaking across the practice.Most teams only see pieces of the problem.

Procedural practices generate the data needed to find denial leakage, underpayments, and cancellation-driven revenue loss. The issue is that the answer is spread across claims, remittance, scheduling, authorization, payer, and operational files. So revenue integrity questions stay open, and preventable leakage continues.

For Practice Administrators and Operators

Denials keep showing up, but the team cannot clearly see which denial patterns are preventable, which payers are driving them, or which workflows are creating the most leakage.
Prior authorization, eligibility, documentation, and scheduling issues create revenue risk before the claim is ever paid. The problem is knowing which issues matter most financially.
Cancellations and schedule instability are tracked as operational metrics, but leadership cannot easily see the lost procedural revenue by provider, location, payer, or procedure type.

What You Get

A clear view of where operational breakdowns are creating revenue leakage, which issues are most financially important, and which actions should be addressed first.

See what we diagnose

For CFOs and Physician Owners

Underpayments can sit inside claims and remittance data for months because nobody has compared expected reimbursement against what the payer actually paid.
Revenue integrity gaps often look small one claim at a time. Across CPT codes, payers, sites, and providers, those gaps can become material leakage.
Finance leaders need a clean view of where earned revenue is being denied, short-paid, delayed, or lost. Most practices do not have that answer without pulling data from several disconnected systems.

What You Get

A prioritized revenue integrity summary showing where earned revenue is being denied, underpaid, delayed, or lost, with dollar impact attached to each finding.

Start revenue leakage assessment

The question is not whether leakage exists.

The question is where it is happening, why it is happening, what it is worth, and which actions will protect the most revenue.

Prexisio gives procedural practices clear answers across denial leakage, underpayments, and cancellation-driven revenue loss, without adding another software system for the team to manage.

Start revenue leakage assessment See what we diagnose

The revenue integrity questions your data should already be answering.

Denials, underpayments, and cancellations all create leakage. The issue is that most practices cannot see the full pattern, the dollar impact, and the next best action in one clear answer.

Which denials are preventable, recurring, and costing the practice the most?

Most practices can see denial volume. Fewer can clearly separate preventable denial leakage from expected noise, quantify the financial impact, and identify the payer, workflow, documentation, authorization, or eligibility issues behind it.

Denial Leakage

Which denial patterns should leadership fix first?

Not every denial deserves the same operational attention. The highest-value answer is which denial categories are recurring, financially material, and tied to actions the practice can actually take.

Denial Leakage

Where did the practice earn revenue but collect less than expected?

Underpayments often hide inside claims and remittance data. The issue is not just whether a claim was paid. It is whether the payment matched what the practice should reasonably expect by payer, code, procedure, site, and provider.

Revenue Integrity

Which payers, codes, and procedures are creating the largest reimbursement gaps?

Revenue integrity gaps can look small one claim at a time. Across payers, CPT codes, locations, and providers, the pattern can become material leakage that finance teams need to see clearly.

Revenue Integrity

How much procedural revenue is being lost to cancellations and schedule instability?

Cancellation rates are easy to report. The harder question is what those cancellations are worth, which appointment types are driving the loss, and whether open capacity is being refilled fast enough.

Cancellation Impact

Which providers, locations, procedures, or payer groups are most exposed to schedule leakage?

Schedule instability becomes a revenue integrity issue when high-value procedural capacity goes unused. Leadership needs to know where the leakage is concentrated and which operational actions matter most.

Cancellation Impact

Every question above can be answered from the practice’s own claims, remittance, and scheduling data. Prexisio turns those answers into clear actionable items instead of another dashboard for the team to manage.

See how we answer them

The benchmarks make the leakage visible.

Prexisio uses the practice’s own claims and scheduling data to compare denial leakage, registration-driven denials, underpayments, and cancellation impact against the financial patterns leadership needs to act on.

15%

Industry denial rate benchmark

Used to compare a practice’s overall denial rate against a clear revenue leakage threshold.

<3%

Registration denial benchmark

Used to identify front-end leakage tied to eligibility, authorization, coordination, and claim data issues.

8–15%

Specialty cancellation benchmark range

Used to compare cancellation-driven revenue loss by specialty, including pain management, GI, spine, and orthopedics.

Client files needed to start

Claims and scheduling data are enough to surface denial leakage, underpayments, and cancellation-driven revenue loss.

How the benchmarks are used

Denial Prevention

15%

Overall denial rate benchmark

Prexisio compares denial patterns against this benchmark, then prioritizes the denials creating the greatest financial impact.

Front-End Revenue Leakage

<3%

Registration denial benchmark

Eligibility, authorization, coordination, and claim data issues are separated from broader denial noise so teams can see what is preventable.

Revenue Integrity

Allowed vs. Paid

Underpayment detection logic

We compare what was allowed, what was paid, and where reimbursement gaps appear by payer, CPT, and procedure.

Cancellation Impact

8–15%

Specialty benchmark range

Cancellation performance is compared by specialty, then translated into estimated monthly revenue impact when the practice is above benchmark.

Benchmarks do not replace client-specific analysis. They create the comparison point. The actual opportunity is calculated from the practice’s own claims, remittance, and scheduling files.

Your vendors help run the practice.Prexisio shows where revenue is leaking.

Most practices already have billing systems, scheduling tools, EHR reports, and advisors. The gap is not activity. The gap is a clear answer to where denial leakage, underpayments, and cancellation-driven revenue loss are happening, what they are worth, and what leadership should do next.

What Prexisio delivers

Denial leakage prioritized by preventability, recurrence, payer behavior, root cause, and dollar impact
Underpayments surfaced from allowed versus paid patterns across payers, CPT codes, providers, procedures, and locations
Cancellation-driven revenue loss translated from scheduling activity into financial impact and unused procedural capacity
ERRC actions that show what to eliminate, reduce, raise, and create so you know what to do next
Clear findings delivered directly to your inbox, with secure portal access available when you want to go deeper
Specific dollar impact from your claims, remittance, and scheduling data

RCM Vendors

Submit claims, manage collections, work denials, and support billing operations.

They often work the problem after revenue has already been denied, delayed, or short-paid. They may not show leadership which denial patterns are preventable, what the leakage is worth, and which fixes should be prioritized first.

EHR Analytics

Report on encounters, appointments, patient records, and activity inside the EHR.

They provide a single-system view. Revenue leakage usually sits across claims, remittance, scheduling, authorization, payer behavior, and operational files. The full answer requires those pieces to be connected.

Scheduling Tools

Support reminders, waitlists, patient communication, and schedule management.

They can help manage appointment activity, but they usually do not quantify the revenue impact of cancellations by procedure, provider, location, payer, and refill opportunity.

Consultants

Assess operations, recommend process changes, and advise leadership teams.

They can identify broad improvement areas, but you still need a recurring way to quantify leakage, monitor patterns, and receive specific recovery actions from their own data.

Where Prexisio fits

Managed revenue intelligence. Built for procedural practices. Delivered without adding another system to manage.

Prexisio gives leadership a recurring view of where revenue integrity is breaking down across denials, underpayments, and cancellations. The output is not another dashboard to adopt. It is a clear, prioritized set of actionable items delivered from the practice’s own data.

Revenue Leakage Visibility

Consultants

Broad recommendations. Limited recurring leakage monitoring.

PREXISIO

Denials, underpayments, and cancellations translated into preventable action items.

RCM Vendors

Billing operations and collections. Often after leakage occurs.

EHR Analytics

Internal reporting. Usually not claims, remittance, and scheduling together.

← Tool-ledManaged partner →

Prexisio does not ask you to manage another system. We use the your data to show you the revenue leakage, quantify the impact, and deliver the next best actions.

See what we diagnose

A managed process, not another system to manage.

Prexisio keeps the client experience simple. You provide the data. We do the work. Your leadership team receives clear revenue leakage findings and prioritized revenue integrity actions.

Initial assessment

Start with a revenue leakage assessment

We begin by understanding where revenue integrity may be breaking down across denials, underpayments, and cancellation-driven revenue loss. The goal is to identify whether there is a meaningful opportunity worth pursuing.

This is focused on the client’s revenue questions, not a software demo.

Client files

Share claims and scheduling data

The client provides the files needed to evaluate revenue leakage. From there, Prexisio handles the analytical work and keeps the client experience lightweight.

No new software to implement. No dashboard your team has to manage.

Delivered to inbox

Receive prioritized revenue integrity actions

Leadership receives a clear summary of where revenue is leaking, what the issue is worth, and which actions should be addressed first across denial leakage, underpayments, and cancellations.

The output is built for action, not analysis paralysis.

Ongoing intelligence

Monitor leakage over time

Prexisio continues to monitor revenue integrity patterns as new data becomes available, helping the practice see whether leakage is improving, shifting, or recurring.

Your team gets ongoing visibility without owning the analytics function internally.

The assessment is where it starts.

Start with the revenue integrity questions that matter most: where denials are recurring, where payments may be short, and where cancellations are creating avoidable revenue loss.

Start Revenue Leakage Assessment See What We Diagnose

Built for procedural specialties.Not generic healthcare reporting.

Denials, underpayments, and cancellations do not look the same in every specialty. A procedural practice needs revenue integrity answers that reflect how its procedures are scheduled, authorized, billed, paid, and lost.

Prexisio focuses on procedural practices where small breakdowns in claims, payment, authorization, and scheduling activity can create meaningful revenue leakage across providers, locations, procedures, and payers.

Different denial patterns

The denials that matter most vary by specialty, procedure mix, payer requirements, and operating model. Leadership needs to know which patterns are preventable, recurring, and financially meaningful.

Different reimbursement risk

Underpayments and payment variance can look very different across procedures, sites, payers, and provider groups. Revenue integrity requires specialty context.

Different capacity impact

A cancelled visit, procedure, or surgical case does not carry the same financial impact across specialties. The revenue effect depends on what was cancelled and whether capacity was reused.

Pain Management

Denial leakage tied to authorization, eligibility, documentation, and payer behavior
Underpayments and reimbursement variation across procedures, payers, and locations
Cancellation-driven revenue loss from missed or unstable procedural volume
Revenue integrity patterns across office, ASC, and procedural workflows

See revenue leakage in pain management

Gastroenterology

Denial patterns across high-volume procedural claims and payer requirements
Revenue integrity gaps across endoscopy, office, and ASC reimbursement activity
Cancellation impact from unfilled procedural capacity and schedule instability
Payer, provider, and location-level visibility into financial leakage

See revenue leakage in gastroenterology

Spine Surgery

Denial leakage across complex procedures, authorization requirements, and payer rules
Underpayments and reimbursement gaps across high-value surgical cases
Cancellation-driven revenue loss from unused surgical and procedural capacity
Revenue integrity visibility across surgeons, sites, procedures, and payers

See revenue leakage in spine surgery

Orthopedics

Denial leakage tied to payer requirements, documentation, authorization, and coding patterns
Underpayments across procedures, implants, payers, providers, and locations
Cancellation-driven revenue loss from schedule instability and unused capacity
Revenue integrity signals across clinic, ASC, and surgical workflows

See revenue leakage in orthopedics

Also relevant for urology, ophthalmology, and other procedural practices with claims, scheduling, and reimbursement complexity.

Not sure where to start? Tell us about your practice and we will help identify which revenue integrity questions matter most.

Proof of work

Built from real work inside procedural healthcare and data operations.

Before Prexisio was positioned as managed revenue intelligence, the work already pointed to the same problem: leaders needed clearer answers from fragmented operational, financial, and healthcare data.

Pain Management · Multi-Site · Tampa, FL

A surgical cancellation problem became a revenue integrity problem.

In a multi-site pain management organization, leadership needed to understand why surgical cancellations were running high and where operational breakdowns were affecting procedural volume.

The work connected scheduling, surgical, and supporting operational records into a clearer view of the scheduled-to-performed funnel, including where cancellations were occurring and which factors were contributing to the loss.

Revenue integrity work followed. Contracted allowed amounts were compared against actual payments so leadership could see reimbursement gaps that had not been visible through normal reporting.

30%

Cancellation rate at engagement start

<10%

Leadership target for surgical cancellations

$2M+

Underpayment gap identified through contract review

Read the full case study

Gastroenterology · PE-Backed · MSO

Multiple acquired GI practices. Different systems. No unified reporting layer.

A GI management services organization had acquired multiple practices across different markets. Each practice brought its own systems, records, payer mix, and operational processes.

Leadership needed recurring visibility across the organization, including AR aging, monthly billing performance, payer mix, and reporting that could support operating decisions across acquired practices.

The work created a unified reporting layer across the acquired practices and supported recurring monthly reporting without manual assembly.

Recurring monthly reports delivered

Multi

Acquired GI practices unified for reporting

Annual

MIPS submission supported across the organization

Read the full case study

Also trusted by

Pain Management · GI · Spine · Orthopedics · Urology · Ophthalmology

See where revenue integrity may be breaking down.Start with a revenue leakage assessment.

Prexisio helps procedural practices identify where revenue is leaking through denials, underpayments, and cancellation-driven revenue loss. You receive a clear summary of what is happening, what it may be worth, and which revenue integrity actions should be considered first.

Start Revenue Leakage Assessment

No new software for your team to manageBuilt from claims and scheduling dataFocused on revenue integrity actions