For US medical, dental & allied health practices
Is your practice losing revenue through missed bookings and unbilled services?
Missed patient inquiries. Unfilled appointments. Unbilled services. Rejected claims. Your practice could be missing legitimate revenue opportunities at multiple points, from the first patient inquiry through to the final payment. Novada Tech's Patient Revenue Leakage Audit examines your appointment revenue leakage alongside your billing, claims and revenue assurance, and identifies where revenue may be leaking, where processes are weak and what can practically be improved.
Start with a complimentary, no-obligation 30-minute discovery conversation.
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Healthcare practices across the United States
Why Novada Tech
Your practice works hard to care for patients. But is every revenue opportunity being managed properly?
Running a successful healthcare practice involves more than delivering excellent clinical care. It also requires reliable appointment administration, responsive patient communication, accurate billing and effective payment reconciliation.
Yet many practices manage these responsibilities across different people, systems and processes. The front desk handles incoming inquiries. The appointment system tracks bookings and cancellations. Clinicians document services. The billing system processes invoices and claims. The finance team monitors payments.
But who is reviewing how all these processes connect?
At Novada Tech, we help healthcare practices examine the operational journey from patient inquiry to completed appointment, billing and payment. Our audit focuses on three priorities.
Identify missed appointment opportunities
Review how patient inquiries, bookings, cancellations and administrative follow-ups are handled.
Strengthen billing & claims accuracy
Examine whether completed, eligible services have been billed appropriately and whether claims and payments reconcile.
Improve revenue administration
Identify practical workflow improvements that can reduce avoidable administrative breakdowns and improve financial visibility.
We look beyond individual transactions to understand the processes that connect patient access, service delivery and revenue collection.
The problem
Two places your practice could be losing revenue without realising it
Revenue leakage is not always caused by low patient demand. A practice may have a busy reception area, full consulting rooms and an established patient base while still experiencing avoidable administrative and billing inefficiencies. These usually fall into two areas.
One · Patient access & appointment leakage
Patient demand exists, but appointment opportunities may be missed.
- Patient calls that go unanswered during busy periods.
- Inquiries that do not result in a booking.
- Incomplete responses to appointment requests.
- Cancelled appointments that remain unfilled.
- Missed opportunities to offer available appointments to suitable patients.
- Incomplete administrative follow-ups.
- Clinically approved recall activities that remain administratively outstanding.
- Limited visibility into booking conversion and unused appointment capacity.
Every unfilled appointment represents time that cannot necessarily be recovered.
Not every inquiry is clinically appropriate, commercially viable or likely to result in an appointment. Our audit distinguishes genuine opportunities from speculative revenue assumptions.
Two · Billing, claims & revenue leakage
Services may be completed, but the associated billing and collection process may not be working as intended.
- Completed billable services that were never invoiced.
- Incorrect fees or billing amounts.
- Potential underbilling or overbilling.
- Incorrectly recorded or unresolved billing items.
- Rejected Medicare or private insurance claims.
- Unpaid invoices and outstanding patient balances.
- Differences between clinical service records, invoices, claims and payments.
- Unresolved payment reconciliation exceptions.
These two problems can occur independently, or at the same time. A practice may improve appointment bookings but still have billing issues. Another practice may bill accurately but struggle with missed inquiries and unused appointment capacity. Novada's audit is designed to investigate both.
Why this matters
A busy practice is not always an efficient practice
Consider these common operational situations.
The front desk is overloaded
Reception staff are assisting patients at the counter while multiple phone inquiries arrive. Some calls go unanswered, and some inquiries may not receive timely follow-up. The practice may have sufficient patient demand but limited visibility over whether appointment inquiries are being handled effectively.
Cancellations leave appointments unfilled
Patients cancel appointments, sometimes at short notice. Although the practice may have other patients who could use those appointments, there may be no consistent administrative process for offering suitable openings. This can result in avoidable unused appointment capacity.
Completed services are not fully billed
Clinicians deliver services and record their work. However, administrative discrepancies may prevent some eligible services from being correctly invoiced or submitted for payment. Without reconciliation between service records and invoices, these issues may remain unnoticed.
Rejected claims remain unresolved
Medicare, insurer or other claims are rejected or delayed. The reason may relate to eligibility, billing details, documentation, coding or system errors. Where exceptions are not systematically reviewed, legitimate payments may remain unresolved and incorrect claims may go uncorrected.
Management cannot see the entire revenue journey
The practice has separate reports for calls, appointments, completed services, invoicing and payments. But management lacks a consistent view of where administrative bottlenecks or financial discrepancies are occurring.
Novada helps bring the relevant information together, establish what the evidence shows and identify where improvements may be worthwhile.
These scenarios illustrate the issues an audit can investigate. They do not imply that every practice has these problems.
What our audit includes
A comprehensive review of patient access, appointments, billing and revenue assurance
Our Patient Revenue Leakage Audit examines two interconnected pillars, read in sequence: everything that happens before the appointment, and everything that happens after it.
Pillar one · Patient access & appointment revenue leakage
Are patient inquiries becoming appointments, and is available capacity being managed effectively?
We examine the administrative processes that connect patient inquiries with appropriately scheduled appointments.
Patient inquiry handling
- Incoming call volumes and response patterns.
- Missed or unanswered patient inquiries.
- Appointment inquiry response times.
- Inquiry follow-up procedures.
- Appointment requests that remain unresolved.
- Booking conversion reporting, where data is available.
Appointment utilization
- Booking trends and appointment availability.
- Cancellation frequency and patterns.
- Unfilled appointment capacity.
- Administrative cancellation recovery workflows.
- No-show reporting and follow-up processes.
- Opportunities to improve suitable appointment allocation.
Follow-ups & clinically approved recalls
- Outstanding practice-approved follow-up tasks.
- Clinician-approved recall administration.
- Reminder workflow completion.
- Documentation of contact attempts where required.
- Administrative handover and escalation procedures.
- Visibility over incomplete follow-up actions.
All clinical recalls, urgency classifications, care recommendations and patient contact instructions remain under the control of the practice and its authorised clinicians.
What this helps identify
- Improve response to patient inquiries.
- Strengthen appointment administration.
- Reduce avoidable unfilled capacity.
- Improve cancellation recovery workflows.
- Strengthen clinically governed follow-up administration.
- Establish clearer appointment and patient-access reporting.
The objective: help your practice make more effective use of appropriate appointment opportunities while respecting patient choice and clinical judgement.
Pillar two · Billing, claims & revenue assurance
Are completed services being billed correctly, and are legitimate payments being collected?
We examine relevant service delivery, invoicing, claiming and payment processes.
Completed services vs. invoices
- Completed services without corresponding invoices.
- Incorrectly recorded or omitted billable services.
- Differences between service records and invoicing.
- Unresolved administrative billing exceptions.
- Weaknesses in the process for confirming billing completion.
Billing & fee accuracy
- Applied fees and billing schedules.
- Incorrect billing amounts.
- Potential underbilling or overbilling.
- Billing data completeness.
- Relevant payer fee schedule applications.
- Service documentation supporting claimed items.
Medicare, private insurance & other claims
- Rejected Medicare claims.
- Unresolved private insurance claims.
- Outstanding VA or other applicable payer claims.
- Claim submission and processing discrepancies.
- Claim rejection reasons and follow-up processes.
- Relevant administrative billing exceptions.
Payments & reconciliation
- Unpaid invoices.
- Outstanding patient payments.
- Claim and remittance discrepancies.
- Differences between invoices and payments received.
- Unallocated or unreconciled transactions.
- Administrative processes for investigating payment exceptions.
Billing code selection, eligibility, clinical entitlement and billing-code accuracy must be verified by appropriately qualified and authorised personnel.
What this helps identify
- Identify legitimately billable services that may have been omitted.
- Improve billing accuracy.
- Strengthen rejected-claim follow-up processes.
- Investigate outstanding legitimate payments.
- Reduce administrative reconciliation exceptions.
- Improve ongoing billing and financial reporting controls.
The objective: not to increase claiming indiscriminately, but to help ensure services are recorded, billed, claimed and reconciled accurately under the applicable rules.
The opportunity
Your practice may already have the patients, appointments and services. The opportunity is in the process.
Improving practice revenue does not always require more advertising or attracting more patients. Sometimes the most useful starting point is reviewing how existing demand and completed services are managed.
Better inquiry management
A structured process for responding to suitable patient inquiries may improve the proportion that result in appropriate bookings.
Improved cancellation recovery
More consistent administrative follow-up may help suitable patients access appointments that become available.
Stronger recall administration
Clinician-approved recalls and follow-ups can be tracked more consistently, supporting continuity of care and reducing incomplete administrative tasks.
More accurate billing
Reviewing completed services against invoices can help identify legitimate billing omissions and other discrepancies.
Fewer unresolved claims
Clearer exception reporting and follow-up processes can help the practice investigate rejected or delayed claims.
Better revenue visibility
Connecting appointment, service delivery, billing and payment records can help management identify process weaknesses and make informed decisions.
Revenue leakage is not always a patient acquisition problem. It can be an operational process problem.
Our audit helps determine whether that applies to your practice, and what the evidence indicates should happen next.
Your own numbers
What unused appointment time is worth over a year
Your numbers, not ours
What is a year of appointment time nobody scheduled actually worth to your practice?
What is true for you
Unused appointment time, at your fees, gross
$172,800
What would be left after the cost of delivering it: $60,480
- 20 hours × $180 = $3,600 of unused appointment time a week
- $3,600 × 48 weeks = $172,800 a year, gross
- 35% of $172,800 = $60,480 left after the cost of delivering it
At that rate, the part worth looking at is $34,560 a year.
After the cost of delivering it: $12,096
Your own arithmetic, on the figures you entered. The starting values are placeholders, not benchmarks. Not every unused hour can be filled, and the percentage is yours rather than a result we promise.
Our approach
We do not just look at bookings. And we do not just look at billing.
Many practices review their appointment books and billing reports separately. Novada takes a connected approach to the administrative and financial processes behind practice operations.
We examine the full administrative revenue journey
From initial patient inquiry through to appropriate appointment booking, completed service, invoice, claim and payment.
We use your existing records
We review available appointment, practice management, billing and financial information rather than relying solely on industry averages.
We distinguish opportunity from earned revenue
An unfilled appointment is a potential capacity opportunity, not an amount automatically owed. A completed eligible service that has not been billed may represent a different type of financial discrepancy. We distinguish these carefully in our findings.
We consider accuracy as well as revenue
Our review investigates potential underbilling and overbilling, documentation issues and claims that may require correction.
We respect clinical decision-making
We do not determine whether a patient needs treatment, whether a recall is clinically required or which service is medically appropriate. Those decisions remain with the practice's qualified clinicians.
We focus on practical improvement
Our goal is to provide management with clear findings, relevant evidence and an actionable roadmap.
Better patient access administration. Stronger billing assurance. Clearer revenue visibility.
Who we work with
Designed for US medical, dental and allied health practices
Our Patient Revenue Leakage Audit is designed for established healthcare practices that manage patient appointments, service delivery records and billing processes.
Primary care practices
For primary care practices managing high inquiry volumes, appointment scheduling, patient recalls, Medicare billing and practice administration. We review relevant patient access workflows, appointment utilization and billing assurance processes.
Specialty medical practices
For specialty practices managing referrals, consultations, procedures, follow-up appointments, private billing, Medicare and insurer claims. We investigate relevant administrative booking, invoicing, claiming and reconciliation workflows.
Allied health practices
For practices delivering services such as physiotherapy, psychology, occupational therapy, speech pathology, podiatry and other allied health disciplines. We examine appointment administration, cancellation patterns, applicable billing processes and payment reconciliation.
Multidisciplinary practices
For healthcare organizations managing multiple practitioners, specialties, locations or appointment types. We review agreed workflows across relevant service lines to identify inconsistencies and improvement opportunities.
Whether you manage a single clinic or multiple practice locations, the audit is tailored to your operating model, available systems and agreed scope.
Our commitments
Built around the real operational challenges healthcare practices face
Healthcare practices rely on multiple administrative functions working together. Appointments need to be scheduled appropriately. Patients need clear communication. Clinical services must be documented. Billing needs to be accurate. Claims must comply with relevant requirements. Payments need to be reconciled.
At Novada Tech, we believe these processes deserve the same operational discipline as other critical business functions. Our audit is designed around four commitments.
Evidence-based analysis
We use available practice records and clearly identify assumptions and data limitations.
Respect for clinical governance
The practice retains responsibility for clinical decisions, recall priorities, patient suitability and treatment recommendations.
Billing accuracy & accountability
We investigate potential billing discrepancies without assuming that every opportunity is recoverable or claimable.
Actionable findings
We focus on practical administrative improvements that management can assess and implement.
How the audit works
Four steps to understanding your practice's revenue processes
Initial discovery conversation
A complimentary 30-minute conversation about your practice type and number of practitioners, your appointment and patient inquiry processes, your current booking and practice management systems, your billing and claims arrangements, the administrative workload and any existing concerns. The objective is to determine whether the audit would be appropriate.
Scope & information review
We agree the audit scope, review period, deliverables, fees and information requirements. Relevant information may include aggregated call and inquiry reports, appointment and cancellation reports, administrative follow-up records, clinician-authorised recall workflow reports, completed service records, invoices and billing reports, Medicare and insurer claim reports, and payment reconciliation information.
Patient access & financial analysis
We examine relevant records to identify inquiry handling weaknesses, booking and cancellation patterns, administrative follow-up breakdowns, potential unbilled eligible services, billing and claims discrepancies, and outstanding payment reconciliation exceptions. Where data supports it we quantify identified discrepancies, distinguishing confirmed findings from assumptions.
Findings & improvement roadmap
We present the findings and explain the implications for your practice. The deliverables include a prioritized improvement roadmap covering the relevant patient access, appointment administration, billing and reconciliation processes.
We seek to use de-identified or aggregated records where sufficient, and agree secure access procedures for any necessary sensitive information.
What you receive
More than an audit report. A practical revenue improvement roadmap.
Our Patient Revenue Leakage Audit provides agreed deliverables tailored to your practice.
Patient access & appointment findings
A review of inquiry handling, booking conversion where measurable, cancellations, unused capacity and relevant administrative follow-ups.
Billing & claims assurance findings
Identification of potential unbilled eligible services, incorrect billing records, rejected claims and payment discrepancies.
Revenue opportunity assessment
A structured assessment distinguishing supported outstanding receivables or billing discrepancies, potentially legitimate revenue requiring verification, and appointment capacity and workflow improvement opportunities.
Operational process review
Identification of relevant weaknesses in appointment administration, service-to-billing workflows, exception tracking and financial controls.
Prioritized improvement action plan
Clear recommendations organised according to potential impact, urgency, feasibility and implementation requirements.
Management findings walkthrough
A discussion of your audit results, supporting evidence and recommended next steps.
Our goal is to give your practice a clearer picture of its revenue processes and practical information to support improvement decisions.
Financial opportunities are assessed using available evidence. Cost savings, increased bookings and revenue recovery are not guaranteed.
After the audit
Finding the problem is the first step. Building better processes is the next.
A one-off audit can help identify where appointment administration or billing controls need improvement. But keeping those processes working consistently requires ongoing attention. Following the audit, practices can choose to implement recommendations internally or explore additional support from Novada Tech.
Introducing Novada's Patient Scheduling & Retention Continuity service
Our separate managed service provides ongoing administrative support across agreed areas of practice operations, including:
- Unlimited telephone-answering support during agreed service hours, subject to defined service capacity and operating terms.
- Administrative support for booking, rescheduling and appointment inquiry management.
- Practice-approved administrative follow-up coordination.
- Administrative support for recalling patients when authorised and directed by the practice's clinical team.
- Follow-up and rebooking administration for suitable patients when appointments become available.
- Administrative support for invoicing, claims processing, rejected-claim follow-up and payment reconciliation.
The audit helps your practice identify where revenue may be leaking and where processes are weak. The managed service helps your practice maintain agreed administrative workflows on an ongoing basis. Both are available independently, and you do not need to purchase an audit before engaging the managed service.
Questions
Frequently asked questions
What is a Patient Revenue Leakage Audit?
It is an operational and financial review of relevant patient inquiry, appointment administration, service billing, claims and payment processes. The purpose is to identify potential revenue discrepancies, missed administrative opportunities and workflow improvements.
Does the audit cover both bookings and billing?
Yes. Our review examines two distinct areas: patient access and appointment revenue leakage, and billing, claims and revenue assurance. The agreed scope determines which records, periods and processes will be analysed.
Can the audit help identify missed patient inquiries?
Yes. Where reliable inquiry and appointment data is available, we can assess relevant response patterns, incomplete inquiry follow-ups and booking processes. We do not assume that every missed call would have resulted in a patient booking.
Does the audit include cancellations and no-shows?
Yes. We review relevant cancellation and no-show patterns, appointment utilization and administrative recovery processes. Any recommendation must respect patient choice, practitioner availability and clinical suitability.
Do you review patient recalls?
We can examine the administrative processes used to track and coordinate practice-approved recalls and reminders. The clinical decision to recall a patient, the urgency of contact and the appropriate clinical response remain the responsibility of authorised clinicians.
Does the audit cover Medicare billing?
Yes. The agreed scope can include identifying billing discrepancies, claim exceptions and relevant Medicare administrative processes. billing code eligibility, appropriate item selection and clinical entitlement decisions must be verified by appropriately qualified and authorised personnel.
Can you review private insurance claims?
Yes. Where relevant to the practice and included in the scope, we can investigate claim rejections, billing discrepancies and payment reconciliation exceptions.
What if our practice already has billing software?
That is fine. Our audit is designed to examine relevant information from your existing systems, subject to data availability and secure access arrangements. We are not proposing that you replace your software simply to conduct the review.
Can you guarantee that we will recover lost revenue?
No. The audit identifies supported discrepancies and potential opportunities. Whether an amount is legally claimable, recoverable or capable of correction depends on the facts, applicable rules, payer requirements and any relevant time limits.
Does the audit replace a Medicare compliance audit?
No. This is an operational and revenue assurance review. It does not replace a statutory audit, formal regulatory review or specialist legal, accounting or clinical advice.
How much does the audit cost?
The fee depends on your practice's size, number of practitioners, locations, systems, data availability and the agreed audit scope, so we confirm it with you before any work begins. The initial discovery conversation is complimentary.
How long does the audit take?
The delivery schedule depends on the complexity of your practice, the review period and the availability and quality of relevant records. We confirm the expected timeline and deliverables before commencing.
Will Novada require access to patient records?
We aim to use aggregated or de-identified information wherever sufficient. If access to identifiable health information is necessary, this must be separately justified, authorised and managed through appropriate privacy, confidentiality, security and access arrangements. Please do not send patient names, medical histories, clinical results or other sensitive information through our website inquiry form.
Can Novada help after the audit?
Yes. Depending on your practice's requirements, we can discuss ongoing administrative support through our separate Patient Scheduling & Retention Continuity service. You may also implement the recommendations internally.
Is this suitable for a small practice?
Potentially. The audit is most appropriate where there is enough appointment, billing or operational activity to justify a structured review. Our discovery conversation helps assess whether there is a reasonable business case.
Book
Your practice may already have the demand. Let us find out whether the revenue processes are keeping up.
Every patient inquiry deserves an appropriate response. Every available appointment should be managed effectively. Every completed billable service should be recorded accurately. Every legitimate claim should be properly submitted and followed up. Every payment should be reconciled. But how confident are you that these processes are working together across your practice?
Book your free 30-minute patient revenue discovery call. During the conversation, we will:
- Understand your practice's operations and current challenges.
- Discuss patient access, booking, billing and claims processes.
- Explain what the audit reviews and how it works.
- Determine whether a comprehensive review would be appropriate.
- Outline the potential next steps and indicative pricing.
The initial discovery conversation is complimentary. The comprehensive audit is a separately scoped, paid service.