Map where revenue is leaking. Quantify what AI can recover.
A 2 to 4 week deep diagnostic of 12 to 18 months of your claims and remittance data. Digital Scientists delivers a board-ready picture of revenue leakage, a ranked opportunity map, and a 60 to 90 day pilot plan tied to the highest-ROI opportunity your finance team will accept.
Want a faster decision on one workflow first? Start with the RCM AI ROI Deployment Assessment (1 to 2 weeks, $10K).
Diagnostic window
Fixed-fee, scope-driven
Claims data analyzed
RCM proof point
You may need this if…
Hospital CFOs, CEOs, COOs, Revenue Cycle Directors, PFS Directors, and CIOs. Health-system finance leaders. Revenue-cycle partner firms preparing a hospital pitch. If any of the signals below sound familiar, the audit is built for you.
Your denial data is messy, multi-payer, and hard to talk about with the board
A/R aging or write-offs are creating financial pressure and you need a credible plan
Multiple facilities or service lines have inconsistent denial patterns and you do not know why
You have heard the AI pitch from multiple vendors and want an independent diagnostic first
You need a board-ready story on revenue leakage, not just a vendor scorecard
You are a revenue-cycle partner firm and you need a diagnostic to bring to a hospital client
Six deliverables. Board-ready.
Before we build anything, we map where your revenue is leaking and quantify how much you can recover. Every artifact is yours regardless of whether we build the pilot.
Deliverable 01
Revenue Cycle Health Scorecard
Denial rate, clean claim rate, A/R days, write-off rate, underpayment indicators—broken down by payer, facility, and provider. One picture, fact-based, board-ready.
Deliverable 02
Denial Taxonomy
CARC and RARC codes normalized to root-cause buckets. Auth, eligibility, medical necessity, coding, timely filing, payer behavior. The taxonomy you can actually act on.
Deliverable 03
Pareto Analysis
Top 10 denial buckets ranked by denied dollars, not count. Most denial dashboards rank by volume and miss the dollars. We rank by what is actually leaking.
Deliverable 04
Opportunity Ranking
Each opportunity scored on three axes: dollar impact, preventability, and data readiness. A single ranked list your finance and operations leaders can debate.
Deliverable 05
Intelligence Layer Briefs
Top 3 to 5 AI intervention opportunities with expected ROI ranges, workflow context, and the human-in-the-loop pattern that would deploy them.
Deliverable 06
60 to 90 Day Pilot Plan
Tied to the highest-ROI opportunity your finance team will accept. Baseline measurement, success metric, governance plan, build sequence. The bridge from diagnosis to deployment.
Four weeks. Six artifacts.
Fixed-window engagement. PHI handled under BAA, CIO included from day one. Your operators stay in control; we do the analytical lift.
Week 1
Data intake under BAA
Claims, remittance, write-off, A/R aging, payer-mix exports. We document chain of custody and confirm the analytical boundary with your CIO.
Week 2
Scorecard + Taxonomy
Revenue Cycle Health Scorecard built. CARC and RARC codes normalized to root-cause buckets. First read-out with your revenue-cycle leaders.
Week 3
Pareto + Ranking
Top 10 denial buckets ranked by denied dollars. Opportunity Ranking scored on dollar impact, preventability, and data readiness.
Week 4
Briefs + Pilot Plan
Top 3 to 5 Intelligence Layer Briefs. A 60 to 90 day pilot plan tied to the highest-ROI opportunity your finance team will accept. Final read-out.
What you keep
All six artifacts. The data normalization work. The taxonomy. The ranked opportunity list. The pilot plan. Yours, whether or not Digital Scientists builds the pilot.
Which one fits?
Two tiers. The audit is the full map. The assessment is the fast decision. Many clients run the assessment first; some go straight to the audit when the board needs the whole picture.
Revenue Integrity Audit
2 to 4 weeks · $15K–$25K
Deep diagnostic of 12 to 18 months of claims and remittance data. You leave with a map, a ranking, and a pilot plan.
Pick this if
- ·The board needs a credible picture of revenue leakage
- ·Multiple service lines or facilities, inconsistent patterns
- ·You want an independent diagnostic before another vendor pitch
- ·You want the deliverables even if you do not build with us
RCM AI ROI Deployment Assessment
1 to 2 weeks · $10K fixed-fee
Decision sprint on one specific workflow. You leave with a proceed / wait / fix-readiness recommendation.
Pick this if
- ·You already know the workflow you want to test
- ·You need a fast decision, not a full map
- ·Your data picture is already credible to your finance leaders
- ·You want to scope a pilot before scoping a program
$24M+ in documented revenue impact.
CommuniCare MDS Optimization is the post-acute revenue-cycle proof point. The operating model translates to acute hospital revenue cycle: data diagnostic first, then workflow intelligence layered on existing systems, then measured revenue lift, with client-owned IP throughout.
CommuniCare MDS Optimization
AI-powered MDS coding for one of the nation's largest post-acute care providers, across 350+ facilities. Workflow intelligence layered on the existing EHR, measured revenue lift, IP that stays with the client.
Revenue Impact
Facilities
Client-owned IP
I have worked with many technology teams during my career, and Digital Scientists is one of the best. They take the time to understand the customers' needs, deliver innovative solutions, are always professional, and work with your team as a true partner to achieve success.
Amy Severino
Chief Innovation Officer, NeverAlone (CommuniCare)
Map where revenue is leaking.
A 30 minute conversation to understand your revenue-cycle pressure, your data picture, and whether the audit fits. No pitch deck.
Or call: 404.654.3855
How is this different from the RCM AI ROI Deployment Assessment?
Two tiers. The Revenue Integrity Audit is a 2 to 4 week, $15K to $25K deep diagnostic of 12 to 18 months of claims and remittance data, with a full revenue-cycle scorecard, denial taxonomy, and intervention briefs. The RCM AI ROI Deployment Assessment is a lighter 1 to 2 week, $10K decision sprint focused on whether one specific workflow has enough value and readiness to justify building. Pick the audit if you want a full map. Pick the assessment if you want a decision.
What if our denial data is messy or incomplete?
That is common and expected. Part of the audit is normalizing the data we receive. We work with whatever exports you can produce, document the gaps, and tell you what the gaps cost you. The audit output identifies the data readiness work that needs to happen alongside any AI investment.
How is PHI handled?
Under BAA, with documented chain of custody. The CIO is included from day one as the governance counterpart. PHI does not leave agreed boundaries.
Do you charge for the audit if we decide not to move forward?
Yes. The audit is the deliverable. The scorecard, denial taxonomy, opportunity ranking, and pilot plan are yours regardless of whether you engage Digital Scientists to build the pilot. Many clients use the audit output to inform internal initiatives or to brief their existing vendors.
Who delivers the audit?
A small, senior Digital Scientists team. Revenue cycle, data, AI, and engineering. Embedded with your finance and PFS operators. Not staff augmentation. Forward Deployed AI Engineering is the delivery model.