Revenue intelligence · Ambulatory surgery centers

What did your center earn last year — and not keep?

Approved cases paid below contract. Receivables nobody reached. Cases that cost more than they paid. Rework that became a hire. No system you run can total the four. Approva does — on your own data.

Revenue diagnosticsRidgeline Surgical · 4 ORs · 3,950 claims · Last 12 months
A/R at timely-filing risk
$74,3009 balances · 30 days
Untouched balances · red inside 14 days$1.41M total untouched A/R
9 d$17,900
6 d$12,400
15 d$9,200
21 d$8,700
18 d$6,100
29 d$5,700
27 d$5,600
12 d$4,800
24 d$3,900
Any figure → the cases behind itAsk Approva AI
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Ask Approva AI

Ask the book of business a question.

Ask in plain language — which payer underpays a procedure, what is about to age out, where block time loses money. The answer comes back as the number, the chart behind it, and a link into the screen with the filter already applied. It reads your remittances, your contracts, your schedule — not a general model of healthcare.

Every answer links to the screen it came from

app.approva.health/askSample data
Ask Approva AIRidgeline Surgical · Last 12 months

The revenue leak

Ask what denials cost and you get a number. Ask what the leak costs and you get a pause.

Revenue leak is the money a surgery center earned and did not keep. Not the cases it never had — the cases it performed. It leaves in four ways, and it stays invisible because each one lives in a different system, in a different unit, on a different clock.

01 · Approved and paid short

The remittance pays less than the contract says.

The authorization came back affirmed, the case was performed, the claim went out clean, and the remittance paid less than the contract says. Nothing about it looks like a failure, which is why it is the largest and quietest of the four.

02 · A/R nobody ever touched

Uncollectible by rule, not by decision.

Every work queue has a tail no one reaches. Balances age past 90 days, then 180, then past the timely-filing window — uncollectible by rule, not by decision.

03 · Cases that lost money before they started

The margin on a case is never computed.

Reimbursement sits in the practice management system. Implant cost sits in materials management. Nothing joins them, so the margin on a case is never computed, and the pattern is never seen.

04 · Rework that shows up as headcount

It surfaces as “we need another biller.”

Chasing an operative note, resubmitting a pended claim, prepping a peer-to-peer that should not have been needed. None of it is a cost line. It surfaces as “we need another biller.”

The Approva approach

Every system holds one true fragment. No system holds the arc.

Product 01 · Approva Moneyleak Diagnostics

The four leaks, totaled on your own data.

A read-only diagnostic on the data your center already produces — claims and remittances, the A/R aging, contracted rates, implant and supply cost. Nothing to install in the OR, nothing written back to your systems. Your billing team works from it every day; the people who own the number read it once a month.

Underpayments

Every payer, every code, paid against the contract.

Remittances compared line by line to the rate the contract specifies, so underpayment stops reading as success.

Aged A/R

The A/R tail, surfaced before the window closes.

Untouched balances ranked by what is still collectible and how many days remain to file.

Case margin

Which cases make money, which lose it, and why.

Reimbursement joined to implant cost and OR minutes, so the negative-margin payer-and-procedure pairs stop hiding for years.

One center or a whole portfolio — the same view rolls up across every site.

See Moneyleak Diagnostics →

What you get

What you walk away with.

The dashboard runs on the exports your systems already produce. From the first refresh, this is what exists that did not exist before.

01

A number for the leak.

The four leaks totaled — and split by payer, procedure, surgeon, and month — on one screen you can put in front of the board.

02

Underpayments you can take to the payer.

Every remittance line short of contract, with the shortfall by code and quarter, exportable as the evidence for a demand or a renegotiation.

03

A/R ranked by what is still collectible.

Days to the timely-filing deadline on every open balance, so the tail gets worked before it ages out by rule.

04

Margin on every case.

Which payer-and-procedure pairs lose money, so you can renegotiate the rate, standardize the implant, or stop taking the case under that contract.

05

Rework you can measure, then reduce.

Where the office's hours go — chased documentation, resubmissions, peer-to-peer prep — so the next hire is for volume, not rework.

06

One view across every center.

Leak and recovery rolled up by site for the CAO, the CFO, or the operating partner, with the drill-down to the case behind every number.

Your numbers depend on case mix, payer mix, and how the office works today — the demo puts the four leaks on screen against yours.

Product 02 · Prior authorization

Once you can see where it leaks, fix it upstream.

Most of the leak that starts with an authorization is decided before the case is ever submitted. Approva assembles the payer-specific medical-necessity packet from the chart — the criteria, the citation, the page in the record — and a certified reviewer audits every case before it goes out. Every payer response trains the system. Every authorized case flows into the dashboard, so the diagnosis and the treatment read from the same record.

From scheduled case to collected payment

From the business office to the boardroom

Built for the team — and the people who own the number.

For the billing team

A working surface, not a report. Sortable queues, drill-to-case, days-to-deadline on every open balance, a weekly digest, and Ask Approva AI for plain-language answers about the book of business.

See the dashboard →

For the people who own the number

The CAO, the CFO, the RCM director, the operating partner. Leak and recovery rolled up across one center or every center you run — the number the board asks for, with the drill-down behind it.

See the dashboard →

FAQ

Frequently asked questions

See it on your own case mix

The number exists. Your systems just can't produce it.

If the question in the headline has no answer inside your own systems, that is the normal condition, not a failure of your team. Thirty minutes, the four leaks on screen against the shape of your case mix.