What We Diagnose

Eight deliverables.One connective layer.

Every Prexisio deliverable is built to answer a specific question your current systems cannot answer on their own. Not because the data does not exist — but because it lives across systems that have never been connected.

Why these deliverables require a layer your systems do not have

Your EMR, your ASC platform, and your billing system each assign a different patient ID to the same person. Cross-system analysis — the kind that answers why your cancellation rate is 28% — requires resolving those identities into one record before running a single query.

Prexisio builds that bridge first. Every deliverable below runs on top of it. None of them are possible without it.

Integy (EMR)

Scheduling, appointments, referrals, diagnoses, charges

Appointment

Encounter

HST Pathways (ASC)

Surgical records, clinical timing, billing, ERA payments

t_visit

t_visitclinical

Billing Systems

Claims, ERA payments, payer remittance, contract data

ERAPayment

EdiInsuranceCoverage

Patient Identity Bridge

Cross-system patient matching — the layer that makes everything else possible

Integy PersonNumber ↔ HST PatientID

DOB + LastName + FirstNameInitial match

The eight deliverables

Each deliverable is built on verified field names from your live systems — not assumed. Every query is documented. Every number is sourced.

D1
Cancellation Intelligence
Monthly

Scheduled-to-Perform Funnel

Monthly cohort analysis of every case scheduled — how many were performed, cancelled, rescheduled, or no-showed. Tracked across all locations with 12-month trend.

The question this answers

Of every surgery we scheduled this month, how many actually happened and why?

Integy Appointment tableHST t_visitApptStatusCancelReasonCode
D2
Cancellation Intelligence
Monthly

Cancellation Root Cause Report

Full decomposition of every cancellation by window (48-hour, 24-hour, date-of-service), location, referral source, payer, provider, and reason code. Revenue impact calculated per segment.

The question this answers

Which locations, referral sources, and payers are driving our cancellation rate — and what is each one costing us?

CancelReasonDescRefDoctorIDReferralSourceApptDate vs CancelDate
D3
Prior Auth Intelligence
Weekly

Prior Authorization Risk Dashboard

Forward-looking view of all surgeries scheduled in the next 30 days mapped to prior authorization status. Cases at risk of 48-hour cancellation flagged as CRITICAL.

The question this answers

Which surgeries scheduled in the next 30 days are at risk of cancellation because prior auth has not been confirmed?

HST EdiInsuranceCoverageIntegy ApptDateAuth approval statusPayer
D4
Operational Flow
Monthly

Patient Flow Bottleneck Dashboard

Stage-by-stage patient journey timing from arrival to discharge. Bottleneck identification by stage and location. New vs. established patient split. Best-performing location benchmarked.

The question this answers

Where in the patient journey are we losing the most time — and which locations are doing it better?

HST t_visitclinicalWheelsInTimeWheelsOutTimeAnesStartProcStart
D5
Operational Flow
Monthly

OR Utilization Intelligence

First case start variance, turnover times, block utilization rate, and revenue capacity analysis. Identifies how much revenue capacity is sitting idle in the current schedule.

The question this answers

How much OR revenue capacity is sitting idle — and where specifically is it being lost?

HST t_visitWheelsIn/Out timingRoomIDBlock scheduling data
D6
Revenue Quality
Monthly

Referral Source Intelligence

Volume, cancellation rate, and net revenue per case by referring provider and referral source. Identifies which relationships produce high-margin, low-cancellation cases vs. which are costing the organization.

The question this answers

Which referral sources produce the best cases — and which are quietly driving our cancellation rate?

Integy RefDoctorIDReferralSourceCharge tableCancelReasonCode
D7
Revenue Integrity
Monthly

Revenue Integrity Report

Contract vs. paid reconciliation across all active payers. Underpayment identification ranked by dollar amount. Denial analysis by CPT code. Open claims aging. Prioritized appeal list for the billing team.

The question this answers

Are our payers paying what our contracts say they owe — and how much is the gap?

HST ERAPaymentGetClaimsPayer contract fee schedulest_visitBilling
D8
Revenue Integrity
Quarterly

Payer Mix Profitability

Net revenue per case by payer, CPT code, and location. Collection rate analysis. Payer mix trend. Strategic view for contract renewal conversations and BD allocation decisions.

The question this answers

Which payer relationships are profitable — and which are subsidizing the organization's losses?

HST ERAPaymentCharge tableCPT codesPayer + location breakdown

How the deliverables connect to each other

D1 is the foundation. The scheduled-to-perform funnel produces the cohort that every other cancellation deliverable references. D2 decomposes the cancellations D1 identifies. D3 predicts future cancellations before they happen.

D6 connects referral source quality to the cancellation data in D2 — showing which referring providers are sending cases that cancel at twice the organizational average.

D7 and D8 complete the picture by reconciling what the organization collected against what it was owed — closing the loop from operational performance to financial outcome.

D1 feeds

D2, D3, D6 — all cancellation and referral analysis references the D1 cohort

D2 + D3 together

Retrospective (what cancelled) + prospective (what is about to cancel) — the complete cancellation picture

D4 + D5 together

Patient flow into OR (D4) + OR efficiency once in (D5) — the complete operational flow picture

D6 connects to D2

Referral source quality overlaid on cancellation rate — shows which relationships are profitable and which are driving the rate

D7 + D8 complete

What payers owe (D7) + which payers are worth keeping (D8) — the complete revenue integrity picture

How we deliver

Every deliverable follows the same production standard before anything reaches a client.

Field verification first

Every table name, field name, and filter value is confirmed against your live system before the first production query runs.

28-point QC checklist

Data integrity, logic and calculation, client-facing content, and security — all checked before anything leaves Prexisio.

Delivered by the 3rd

Monthly package delivered by the 3rd of each month for the prior month's data. Prior auth dashboard refreshed every Monday.

Dollar amount on every finding

No finding is delivered without a quantified revenue number. Not a range. Not a benchmark. The number for your organization.

Ready to see what your data actually shows?

The diagnostic starts with a 45-minute conversation. Eleven questions. One specific dollar amount from your actual data. First findings in 30 days.