Primarily fax and paper — manually keyed in

Staff transcribe every document by hand

Mix of fax, email, and portals — no unified intake

Multiple channels, all handled separately

Mostly portal-based with some manual processing

Standardised intake but still some manual steps

Automated intake — documents extracted and structured on arrival

No manual keying required

Fully manual — staff assemble every packet from scratch

Hunting through EHRs and payer portals manually

Basic templates, but clinical notes still require manual review

Partial standardisation, still time-intensive

Semi-automated — system pulls some data, staff complete the rest

Reduces time but still requires significant manual input

Automated — packets built and validated against payer rules automatically

Staff review and approve, not assemble

More than 4 hours per packet

Most of an RN's or specialist's day

2 – 4 hours per packet

Significant time sink per case

1 – 2 hours per packet

Improving but still a bottleneck at volume

Under 30 minutes per packet

System handles the bulk; staff approve

Spreadsheets, sticky notes, or staff memory

High risk of things falling through the cracks

Shared spreadsheet or basic task list

Visible but not automated or real-time

Practice management or RCM system — manually updated

Good visibility, but relies on staff keeping it current

Real-time automated tracking — alerts for pending, denied, expiring

Nothing falls through; team always knows what's next

Over 20%

Significant revenue being lost to preventable denials

10 – 20%

Above industry average — documentation gaps likely

5 – 10%

Near average — room for meaningful improvement

Under 5%

Strong first-pass approval rate

Manual — staff call the payer or check each portal individually

15–25 minutes per verification

Batch eligibility checks — run periodically, not in real time

Better than manual but still causes delays

EDI 270/271 checks run on intake — mostly automated

Good coverage, some edge cases still manual

Real-time automated verification triggered on every document arrival

Zero manual eligibility checks required

Most denials are written off — appeals rarely happen

High revenue loss; rework cost feels too high

Appeals handled ad hoc — no consistent process

Some recoveries but inconsistent and slow

Structured appeals process — tracked, mostly manual

Good recovery rate, but labour-intensive

Denials auto-categorised with appeal drafts generated immediately

High recovery rate with minimal staff effort

5 or more source systems

EHR, fax, portal, billing, radiology — all separate

3 – 4 source systems

Still significant context switching per case

2 systems

Manageable, but still some duplication of effort

Single unified view — all documents in one place

Staff never leave one interface to work a case

No formal tracking — renewals often discovered after lapsed

Regular revenue loss from expired authorizations

Spreadsheet or calendar reminders — manually maintained

Better, but gaps happen when staff are busy

System alerts staff in advance — some manual follow-through

Most renewals caught in time

Renewals automatically triggered and tracked — nothing lapses

Zero revenue lost to missed renewal dates

More than 7 days

Cash flow significantly delayed; care impacted

5 – 7 days

Above average cycle time; room for improvement

3 – 5 days

Industry average — competitive but not best-in-class

Same day to 2 days

Best-in-class; fast cash cycle