Intake Readiness & Revenue Exposure Model

What is your paperwork costing you?

Answer what you know. The model runs on published benchmarks where you don’t — and the number of things you have to leave at benchmark is, in our experience, the more useful answer on this page.

HIPAA COMPLIANTBAA AVAILABLEHL7 FHIRNVIDIA INCEPTION MEMBER
PART ONE

Intake Readiness

Five dimensions, 0–3 each. A low score is not a failing grade — it means the problem is currently invisible, which is worth knowing before anyone spends anything.

Volume visibility

Do you know how many documents/orders arrive per month?

(0 = no idea · 3 = measured & reported)

Detection point

Who finds the defect first — you, or the payer?

(0 = the payer (a denial) · 3 = caught at intake)

Rework load

Do you measure how often a document is re-touched?

(0 = not measured · 3 = tracked per order)

Attribution

Can you trace a denial back to the field that caused it?

(0 = no · 3 = root-caused every time)

Change readiness

Is there a route to pilot without a full procurement cycle?

(0 = none · 3 = fast pilot path exists)
PART TWO

What do you need?

Tick the value-add services in scope, and mark the priority. This shapes the pilot — it does not change the numbers.

EMR / EHR integration
Fax ingestion & auto-classification
Email intake ingestion
Eligibility / benefits verification
Prior authorization automation
Pre-submission denial prevention
Denial management & appeals
Recurring / resupply documentation
Payer-rule & CMS-0057-F checks
Audit trail & reporting
Referral / authorization status tracking
PART THREE

Your Numbers

Volume and denial profile. Every field is pre-filled with a published benchmark — overwrite with your own where you know it.

Documents / orders received per monthcount
Average reimbursement per order$
$
Initial denial rate%
%
Share of denials caused by documentation / front-end%
%
Appeal overturn (success) rate%
%
Share of claims written off%
%
Average days to authorization todaydays
Model assumptions — adjust or challenge any of these
Front-end defects caught at intake%
%
Share of denials actually appealed%
%
Cost to work one appeal$
$
Share of orders needing a second touch%
%
Minutes lost per re-touched ordermin
Fully-loaded coordinator cost$/hr
Platform · Essentials (<500/mo) annual$
$
Platform · Professional (500–2,000/mo) annual$
$
Platform · Enterprise (>2,000/mo) annual$
$
PART FOUR

Common denial patterns

How often does each cause a denial? The model scores how much of your denial mix DocuFindr can rectify before submission.

Eligibility / coverage not verified at registrationYes · pre-submit
Prior authorization missing / invalid (MA & Medicaid managed care)Yes · pre-submit
Missing / invalid physician signature (CMN, DWO)Yes · pre-submit
Incorrect or missing HCPCS / CPT codesYes · pre-submit
Medical necessity / documentation insufficient (LCD, NCD)Yes · pre-submit
Infusion: incorrect dosage or units (J-code units mismatch)Yes · pre-submit
Infusion / drug: non-covered, non-formulary or site-of-careYes · pre-submit
Diagnosis code does not support medical necessityYes · pre-submit
Resupply / frequency too soon (30–90 day rules)Yes · pre-submit
Level-of-care / medical necessity (obs vs inpatient)Partial
Coordination of benefits / wrong payerPartial
Timely filingPartial
MODELLED RESULT
8/15
Readiness: Partial visibility
53
MODERATE fit /100
$46,923
Total annual exposure at intake — revenue & labour at risk from documentation defects.
Revenue never recoveredPreventable denials, net of appeals won
$30,537
Cost of appealingStaff time fighting what could have been caught
$6,786
Rework at intakeSecond touches, chasing signatures
$9,600
Total annual exposure$46,923
Modelled protected valueAt the catch rate in assumptions
$37,538
DocuFindr platformProfessional · implementation not included
$36,000
Modelled net$1,538
Denial patterns rectified90%
Recommended tier: Professional
This page performs arithmetic on figures you supply. It is an estimate, not a forecast or a guarantee. Benchmark defaults draw on published industry sources and will not match any specific organization. Platform pricing shown is an editable placeholder. Nothing entered here leaves your browser.