Before you change anything about your billing, it helps to know exactly where the money is stopping. A revenue audit reviews your oral appliance therapy claims end to end and shows you what is recoverable.
Specialty focus
A/R
Precision at every handoff.
A revenue audit is not a sales exercise. It is a claim-level review of the medical billing side of your dental sleep medicine practice — what was billed, what was denied, what was appealed, and what was never submitted at all.
In oral appliance therapy, revenue rarely disappears in one dramatic event. It leaks through cases delivered without authorization, denials that were never appealed, and aging claims nobody has time to chase.
We look at the full medical billing chain, from benefit verification through collections, and reconcile it against the clinical documentation that supports each claim.
01
Every open medical claim is sorted by age and payer so stalled oral appliance claims stop hiding inside a single total.
02
We separate denials that were appealed from denials that were quietly written off, then group them by reason code.
03
Cases delivered without documented authorization, and authorizations that expired before delivery, are flagged.
04
A sample of E0486 and K1027 claims is checked against the sleep study, physician order and chart notes behind them.
05
Findings become a prioritized list: what can still be appealed, what can be rebilled, and what has to change going forward.
The structure below is the case study format we publish results in: the situation, what the review found, what we changed, and the measured outcome over a defined period.
Practice profile, monthly oral appliance case volume, payer mix, and how billing was handled before the review.
Unbilled or under-billed cases, denials never appealed, authorization gaps, and the documentation patterns behind them.
The pre-authorization workflow, coding corrections, the appeal queue rebuilt, and the follow-up cadence put in place.
Recovered revenue, change in days in A/R, denial rate before and after, and appeal win rate over the measured period.
Note for the Claims Paid Pro team: the numbers for this case study are intentionally left out until a real client engagement is cleared for publication. Send the practice details, before-and-after figures and the time period, and they will be published here with the client's permission. Nothing on this page claims a result we have not measured.
Your practice delivered the care. Let Claims Paid Pro handle the fight to collect what you earned.
