# Analyze my clinic's claim denials and revenue cycle KPIs

Turns denial and A/R data into root causes, benchmark gaps, and a prioritized fix list for the front end, coding, and billing teams.

- Topic: Data & Analysis
- Framework: Few-Shot
- Level: Standard
- Tags: Data & Analytics, Finance, Coding, Analyze, Code, Fill-in Template
- Source: https://www.thinkwithprompt.com/prompts/analyze-my-clinic-s-claim-denials-and-revenue-cycle-kpis

## Prompt

```text
Analyze our clinic's revenue cycle performance and denials.

**Practice type and size:** [e.g. "4-provider family medicine", "multi-site PT clinic"]
**Period:** [e.g. "last 6 months"]
**Denial data:** [PASTE a table or export - claim count, denial reason/CARC code, payer, CPT, location, amount]
**KPIs we track:** [e.g. clean claim rate, first-pass resolution, denial rate, days in A/R, A/R over 90 days, net collection rate, point-of-service collections]
**Payer mix:** [rough percentages]
**Known changes in the period:** [e.g. new EHR, staff turnover, payer policy changes]

Do this:
1. Group denials by root cause category: registration/eligibility, prior authorization, coding/modifiers, medical necessity, timely filing, duplicate/bundling, missing documentation. Show count, dollars, and share of total for each.
2. Identify the top 5 patterns by payer, CPT, location, or provider, and say which are preventable at the front desk, in coding, or in charge entry.
3. Compare our KPIs to commonly cited industry ranges and label each as on track, watch, or problem. If you cite a benchmark range, say it is a general reference to verify against our specialty and payer mix.
4. Flag any data that looks inconsistent or incomplete instead of guessing.

Return:
- A one-paragraph summary for practice leadership.
- A table: Issue | Evidence | Dollars at risk | Owner (front desk / coding / billing / clinical) | Fix | Effort.
- A 30-day action plan with the 3 fixes that recover the most money.
- 3 metrics to monitor weekly and how to calculate each.
```

## What to fill in

- e.g. "4-provider family medicine", "multi-site PT clinic"
- e.g. "last 6 months"
- rough percentages
- e.g. new EHR, staff turnover, payer policy changes

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