Sample audit deliverable
Sample Medical Practice Automation Audit
This sample shows the kind of practical output a medical practice receives after a workflow audit: a clear current-state map, prioritized automation opportunities, staff-review boundaries, and a realistic first pilot recommendation.
Fictional practice snapshot
Example review scenario
This is a fictional example. It is designed to show the structure of an audit deliverable without using patient data, protected health information, or any real practice details.
Appointment-driven specialty office
The practice handles new patient requests, referrals, follow-up visits, procedure scheduling, insurance questions, and recurring manual status checks.
Work around the existing stack
EHR/EMR, practice-management system, patient portal, payer portals, clearinghouse workflow, eFax, phone/SMS, online scheduling, and exports where available.
Manual work before the visit
Staff need better visibility into missing demographics, insurance cards, referral requirements, prior authorization flags, and scheduling dependencies.
Workflow map
How the audit breaks down the work
The audit separates the patient-facing request from the staff queue, the system lookup, the scheduling decision, and the follow-up owner. That makes it easier to see which step should be automated and which step still needs staff judgment.
Capture
Inquiry source, appointment request, referral, insurance card, patient demographics, and preferred contact path.
Review queue
Missing information queue, intake review queue, prior authorization queue, referral queue, and scheduling exception queue.
Staff decision
Scheduler, front desk, billing/RCM, prior authorization coordinator, referral coordinator, or provider owner reviews exceptions.
Measure
Track response time, visit readiness, no-show risk, delayed scheduling, rework, and staff time spent on manual checks.
Example findings
Sample audit output table
A real audit would be specific to the practice. This sample shows the type of operational findings we document and how each recommendation keeps staff review in the loop.
| Workflow | Current issue | Automation opportunity | Staff review needed |
|---|---|---|---|
| Patient intake readiness | Forms, demographics, insurance card images, or referral details arrive incomplete before appointment day. | Create a missing-information queue that flags incomplete intake before the visit and gives staff a clean follow-up list. | Front desk and scheduler |
| Eligibility and benefits | Staff manually check payer portals late in the process, which delays scheduling decisions and creates rework. | Track eligibility status, benefits questions, and coverage uncertainty earlier so staff can resolve issues before the visit. | Billing/RCM team |
| Prior authorization flags | CPT/HCPCS, ICD-10 context, referral requirements, and medical necessity documentation are checked inconsistently. | Flag cases that may need prior authorization or documentation review before scheduling dependencies create a bottleneck. | Prior authorization coordinator |
| Provider routing | Visit reason, procedure type, imaging needs, or provider rules are not always matched before the appointment is selected. | Route appointment requests by visit reason and procedure context, then send exceptions into a scheduling review queue. | Scheduler and provider owner |
| No-show follow-up | Reminder and callback work depends on staff memory, especially after cancellations or unconfirmed appointments. | Create a no-show and cancellation follow-up queue with staff-approved message paths and daily visibility. | Front desk and scheduler |
Patient intake readiness
Current issueIncomplete forms, demographics, cards, or referral details.
OpportunityMissing-information queue before appointment day.
Staff reviewFront desk and scheduler.
Eligibility and benefits
Current issueManual payer portal checks happen late.
OpportunitySurface eligibility status and coverage uncertainty earlier.
Staff reviewBilling/RCM team.
Prior authorization flags
Current issueCPT/HCPCS, ICD-10, referral, and documentation context are checked inconsistently.
OpportunityFlag possible prior auth or document needs before scheduling.
Staff reviewPrior authorization coordinator.
Provider routing
Current issueVisit reason and provider rules are not always matched.
OpportunityRoute appointment requests by reason and procedure context.
Staff reviewScheduler and provider owner.
Security and boundaries
Sample guardrails we document
Minimum necessary data
Use only the data needed for the workflow. Avoid PHI in public forms, define secure intake paths, and review BAA needs before implementation.
Role-based review
Separate what front desk, scheduler, billing, prior-auth, referral, and owner roles should see or approve before action.
No clinical decisions
Automation supports administrative work. Clinical judgment, diagnosis, treatment, and patient-specific medical decisions stay with licensed staff.
Important: The audit is not legal, billing, or clinical advice. It is an operational review that helps the practice identify practical automation opportunities and implementation boundaries.
Recommended first pilot
Example 30-day pilot scope
For this fictional scenario, the recommended first pilot would focus on an intake and insurance-readiness queue because it touches scheduling, staff time, patient preparedness, and preventable rework.
Pilot: visit-readiness queue
- Map intake fields, referral inputs, insurance card capture, and scheduling dependencies.
- Define missing-information, insurance-readiness, and scheduling-exception queues.
- Create staff-reviewed automation rules and a daily summary for practice leadership.
- Track response time, incomplete intake rate, readiness before appointment day, and staff rework.
Deliverable package
What the practice receives
Audit findings
- Current workflow map and staff-owner map.
- Top automation opportunities ranked by impact and complexity.
- Systems, access, exports, API, FHIR, or X12/EDI considerations where relevant.
- Security, PHI, staff-review, and audit-log notes.
Pilot recommendation
- Recommended first pilot and why it should come first.
- Included and excluded scope so expectations are clear.
- Implementation steps with MSP/IT coordination needs.
- Success metrics for the first 30 days.
Ready to see this for your practice?
Request a Medical Practice Automation Audit
We will review the workflow, systems, queue ownership, staff handoffs, and practical automation boundaries before recommending a first pilot.
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