RCM Audit Checklist
RCM audit checklist for performance and financial integrity.
Revenue Cycle Management has a direct impact on financial stability, patient access, staff workflow, and organizational growth. Yet many RCM challenges remain hidden until they create system-wide strain such as increasing denials, delayed reimbursements, declining cash flow, or inconsistent workflows across teams.
A structured audit process helps leadership identify the root causes early and ensure processes are functioning as intended across all stages of the revenue cycle. Our RCM Audit Checklist provides a clear framework to evaluate the strength of your current RCM workflows, identify risks, and prioritize improvements.
What you will learn.
- Patient Access and Front-End Processes: Identify where registration, eligibility verification, and authorization workflows may be creating delays or inaccuracies.
- Charge Capture and Coding Accuracy: Confirm that all services are captured correctly and coding practices are consistently supported by clear documentation.
- Billing and Claims Management: Assess claim submission timeliness, denial management workflows, and processes for identifying underpayments.
- Patient Financial Engagement: Evaluate clarity of billing communication, cost estimate practices, and available patient payment pathways.
- Revenue Cycle Reporting and Analytics: Review KPI monitoring, benchmarking practices, and data-driven decision-making capabilities.
- Compliance and Risk Management: Ensure alignment with HIPAA, payer regulations, audit preparation, and proactive risk mitigation.
John Lynch & Associates supports healthcare organizations in strengthening revenue cycle performance with strategies tailored to their team, workflow, payer mix, and growth goals. Our consulting approach focuses on building repeatable processes, improving transparency across RCM operations, and empowering staff to deliver consistent results with confidence.
We help organizations identify root causes, streamline workflows, and improve financial outcomes while maintaining compliance and quality of care.
