MSOs & Multi-site Medical Groups · MARGIN
Front-End Revenue Cycle & Denial Prevention.
Fewer denials and faster cash, by fixing eligibility, authorization and registration before the claim and working what still denies through prioritized workqueues.
The problem this solves
- Denials that trace back to eligibility, authorization and registration errors at the front desk
- Prior authorization consuming clinical and staff hours every week
- Days in A/R and patient balances rising with volume
What we measure
- Clean-claim rate and initial denial rate
- Days in A/R and cost to collect
- Prior authorization turnaround and staff hours
Every program starts by baselining these numbers in your systems. Results are reported against your baseline, not against industry averages.
The playbook
01
Eligibility and benefits at scheduling
Coverage, benefits and patient responsibility checked automatically when the visit is booked and again before it takes place, with exceptions routed to staff and estimates ready for the front desk.
02
Prior authorization preparation
Authorization requirements identified at order, packets assembled from the chart and submitted through payer portals, status tracked, and clinical questions routed to the clinician.
03
Denial prevention and workqueues
Denials categorized by root cause and payer, fed back to the step that caused them, and remaining work prioritized by value and timely-filing risk.
The market context, in published numbers
82.0%
of US physicians were employed by hospitals or corporate entities, including private equity firms and health insurers, as of January 1, 2026
31 days
average wait for a new-patient physician appointment across six medical specialties in 15 large US metro areas, up 19% since 2022
39
prior authorization requests completed per physician per week on average, taking physicians and their staff an average of 13 hours a week (AMA survey of 1,000 physicians, late 2024)
60%
of medical group leaders reported an increase in claim denial rates versus the same period a year earlier (MGMA Stat poll, 235 responses)
$21B
remaining US healthcare savings opportunity from fully automating manual and partially manual administrative transactions between providers and health plans
CAQH (now DataSpring), 2025 CAQH Index, released February 19, 2026 (2026)
Figures are third-party market benchmarks from the cited sources, not Ometz Partners client results. We share them so you can size the problem before we ever talk.
Capabilities
What the Operations Performance program covers.
Process measurement and redesign
Process mapping, work sampling and system logs to find where time, cost and errors accumulate, followed by a redesigned flow with clear ownership.
Order-to-cash and procure-to-pay
Emailed and PDF purchase orders read into the ERP, invoice matching, deduction and chargeback research, and collections prioritized by risk and value.
Revenue cycle operations
Eligibility, authorization preparation, claim edits and denial work queues for care providers, with root causes fed back to scheduling and intake.
S&OP and planning
A monthly sales and operations planning cycle with demand signals, capacity, inventory and service levels in one view, so plans hold between meetings.
Quality and regulatory documentation
Drafting and assembly of deviations, CAPA records, certificates of analysis, safety data sheets and specifications for review. Your Quality Unit reviews, approves and signs every GMP record.
Financial-services operations
Account opening and transfer paperwork, advisor onboarding files, fee billing and reconciliation, tax and audit engagement preparation, and alert-review preparation, with every decision left to your operations, principal and compliance staff.
Close, reconciliation and reporting
Month-end close tasks, reconciliations and management reports assembled automatically and checked against your controls.
Also in the MSOs & Multi-site Medical Groups program
ACCESS
Patient Access & Referral Performance
Shorter time to appointment and more referrals converted into visits, with scheduling, intake and referrals run as one managed flow across sites.
VALUE CAPTURE
Acquired-Practice Integration
Each acquisition reaches platform performance sooner, on one operating model, with the synergies in the investment case tracked against a baseline.
Next step
Size this opportunity in your own numbers.
The Performance Diagnostic runs for two to four weeks at a fixed fee and ends with a baseline, three priced improvement plays and a 90-day plan. The findings are yours whether or not we continue.