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80+ patterns · Pareto rollups · payer-CPT-provider drill

Where the dollars actually leak.

CARC and RARC reason codes describe what the payer said. Root causes describe what is actually broken. The reason code says "missing modifier"; the root cause says "the EHR template is not propagating the GT modifier for this provider in this payer's network". The first one is a number. The second one is a fix. We carry 80+ root cause patterns and surface the Pareto every month so a billing director knows which 5 fixes move 70 percent of the dollars.

80+ root cause patterns mapped Pareto rollup, monthly CDI feedback to clinicians
The Pareto rollup

The five fixes that move 71%.

An anonymized aggregate from a representative multi-site practice. The denial book carries 80+ root cause patterns, but the top 5 explain 71 percent of the denial dollars in the period. Each pattern carries a dollar value, a count, and a recommended action. The billing director plans the month from this view.

The patterns are not abstract. Each one names the broken thing: which payer's eligibility cache went stale, which provider's documentation is missing the time-based statement, which CPT plus modifier combination is triggering the NCCI edit. The fix is the action that closes the pattern, not a generic "improve documentation" memo.

Top 8 root causes · last 90 days · anonymized
Root cause pattern
Share
$ Impact
Cum %
Credentialing enrollment lapseBCBS · 4 providers · CredPro sync
$214K
28%
Eligibility cache stalenessMedicaid MCO · weekly refresh gap
$138K
46%
Missing GT/95 modifier (telehealth)EHR template issue · 2 providers
$101K
59%
Auth unit balance exhaustionABA · reauth submission gap
$62K
67%
Time-based doc insufficient97155 supervision · 5 clinicians
$33K
71%
Coordination of benefits missingSecondary payer · 38 claims
$24K
74%
Bundling adjustment (NCCI)97153 + 97155 same day
$19K
76%
Timely filing past 90dStuck-claim escalation gap
$15K
78%
Long tail 72 more patterns · 22% of dollars · ranked dollar-by-dollar
The capabilities

Six capabilities. Pattern to action.

Every denial gets classified into a root cause pattern. Every pattern carries a recommended action. The Pareto, the drill-down, the CDI feedback, the clinician scorecard, the executive readout, and the regional benchmark are the views that turn patterns into work.

01 · Pattern classification

80+ patterns, payer-CPT-provider.

Every denial classifies into one of 80+ root cause patterns covering credentialing, eligibility, authorization, documentation, coding, billing rules, and timely filing. Classification uses the 835 CARC/RARC plus the claim context plus the historical pattern library to land on the actionable layer, not the surface signal.

02 · Pareto rollups

Top 5 explain 70%+.

Monthly Pareto rollup ranks root causes by dollar value impact with cumulative percentage. Top 5 typically explain 60 to 75 percent of denial dollars. Fix the 5, move the dollars. The rollup is the primary view a billing director uses to plan the month.

03 · Drill-down

Slice by any dimension.

Drill-down by payer, CPT, rendering provider, location, or any combination. "Show me UHC denials for 97155 in the last 90 days" returns dollar value, count, root cause distribution, trend line. The diagnostic tool that turns a denial number into a conversation with a payer rep or a clinician.

04 · CDI feedback loop

Documentation patterns, fed back.

When the engine identifies a documentation-related pattern, the CDI feedback loop surfaces it in the provider's review queue and in the documentation training module. The denial pattern becomes a coaching opportunity rather than a billing problem. Closing the loop reduces forward denial volume on the same pattern.

05 · Clinician scorecards

Coaching tool, not punitive.

Monthly clinician scorecards rank providers by clean claim rate, first-pass payment rate, documentation completeness, and dollar value of documentation-attributable denials. Used by practice owners and compliance as a coaching input. Not a punitive tool; the scorecards drive training, not termination.

06 · Regional benchmarking

Peer-set anonymized.

Practice denial profile compared against an anonymized peer set: same specialty, same region, similar payer mix. Clean claim rate, denial dollar per encounter, average days to denial, root cause distribution. Peer set composition documented so the practice owner knows what they are being compared against.

How a denial becomes a fix

Four steps. Surface to systemic.

From the moment a denial lands on the 835 ERA to the moment the root cause is mapped to a forward-prevention rule, here is the work the analytics module executes.

Step 01

Classify the denial.

CARC and RARC reason codes are the surface signal. The classifier looks at the claim context, the historical pattern library, and the payer-specific behavior to map the denial to one of 80+ root cause patterns. Confidence-scored.

Step 02

Aggregate to Pareto.

Root cause patterns aggregate by dollar value and count. Pareto ranks the top patterns and shows cumulative percentage. Drill-down by payer, CPT, provider, location. Trend line over the trailing 90 days for each top pattern.

Step 03

Feed back to source.

Documentation patterns route to CDI feedback. Coding patterns route to the coding workflow. Eligibility patterns route to the eligibility cache refresh policy. Credentialing patterns cross-reference CredPro and route to the credentialing team.

Step 04

Prevent forward.

The pattern becomes a prevention rule in the AI Suite. The next claim that fits the pattern signature gets caught at submission instead of denial. Forward denial volume on the closed pattern measurably drops in the next 30 to 60 days.

What the analytics deliver

Measured outcomes from root cause analytics.

Across the active book. Anonymized; individual results depend on payer mix, specialty, and the practice's baseline denial book.

71%
Of denial dollars in the top 5 patterns
On a representative book. The Pareto rollup means a billing director can focus on five fix tracks rather than 80. Closing the top 5 over a 90-day window measurably reduces forward denial volume in the same patterns.
3dim
Drill-down dimensions, fully indexed
Payer, CPT, rendering provider, plus location and date as additional filters. Any combination returns a sub-second response with dollar value, count, root cause distribution, and trend line. The diagnostic tool for the monthly denial review meeting.
30-60d
From closed pattern to denial drop
When a root cause is closed (eligibility cache refreshed, EHR template fixed, credentialing record synced, CDI feedback delivered), forward denial volume on the same pattern drops measurably within 30 to 60 days. The trend line is the proof that the fix landed.
Common questions

Frequently asked questions: root cause analytics.

What is a root cause pattern in this context?
A root cause pattern is the underlying systemic reason a claim denies, not the CARC/RARC reason code the payer returns. The reason code says 'missing modifier'; the root cause says 'this provider is consistently undercoding telehealth in this payer's network because the EHR template is not propagating the GT modifier'. The root cause is the actionable layer; the reason code is just the surface signal. We carry 80+ root cause patterns covering credentialing gaps, eligibility staleness, authorization mismatches, documentation insufficiency, coding errors, billing rule violations, and timely filing failures.
What is a Pareto rollup?
A Pareto rollup is the 80/20 view of the denial book. It ranks root causes by dollar value impact and shows the cumulative percentage of total denied dollars that each root cause contributes. In practice, the top 5 root causes typically explain 60 to 75 percent of the denial dollars on the book. Fixing those 5 carries more impact than chasing the long tail. The rollup is the primary view a billing director uses to plan the month.
How does the payer-CPT-provider drill-down work?
Every denial carries three dimensions: which payer, which CPT (or service code), which rendering provider. The drill-down lets a billing director slice the denial book by any of the three, or any combination. 'Show me UnitedHealthcare denials for 97155 in the last 90 days' returns the dollar value, the count, the root cause distribution, and the trend line. 'Show me all denials for provider 1234 by payer' returns the same. The drill-down is the diagnostic tool that turns a denial number into an actionable conversation with payer rep or clinician.
What is the CDI feedback loop?
CDI (Clinical Documentation Improvement) is the practice of feeding denial patterns back to the clinical documentation workflow. When the engine identifies a pattern like 'this provider's notes are consistently missing the time-based statement that justifies the 97155 supervision unit', the CDI feedback loop surfaces that pattern in the provider's review queue and in the documentation training module. The denial pattern becomes a coaching opportunity rather than a billing problem.
What does a clinician scorecard show?
A clinician scorecard ranks providers by clean claim rate, first-pass payment rate, average documentation completeness, and dollar value of denials attributable to documentation gaps. The scorecard is delivered monthly. Compliance and HR keep a clean view of which providers are exposed to documentation-related denials and which are clean. We do not surface scorecards as a punitive tool; they are a coaching input for the practice owner.
What is in the monthly executive readout?
A two-page summary. Page one: total denials by dollar and count, month-over-month trend, top 5 root causes with dollar value, top 5 payer concentration, top 5 service code concentration, and the recovery action plan for the next month. Page two: clinician scorecard summary, regional benchmark comparison, anomaly flags, and the credentialing-related denial exposure. The readout is built for a practice owner or CFO who has 15 minutes.
How does regional benchmarking work?
Regional benchmarking compares the practice's denial profile against an anonymized peer set: same specialty, same region, similar payer mix. Numbers compared include clean claim rate, denial dollar per encounter, average days to denial, and root cause distribution. The benchmark is built from the ASP-RCM book under strict de-identification. The peer set composition is documented so the practice owner knows what they are being compared against.
How does this connect to CredPro and the AI Suite?
Tight loops in three places. CredPro carries the provider enrollment status per payer; denials attributable to credentialing gaps (lapsed enrollment, missing taxonomy code, expired CAQH attestation) cross-reference CredPro and route to the credentialing team. The AI Suite eligibility and prior auth tools consume the root cause patterns at the point of service so a denial pattern in the data becomes a prevention rule in the workflow. And the 835 reconciliation engine feeds line-level adjustment data into the root cause classifier so partial payments and contractual variances are part of the pattern library.

Send 90 days of denials. We send back the Pareto.

A free 90-day denial root cause audit. Drop your last 90 days of 835 denials and a sample of the related 837s. We return a four-page audit covering top 10 root cause patterns by dollar, payer concentration, clinician exposure, recovery dollar projection, and a 90-day fix plan. A senior partner on the call.