Your practice is losing revenue in places you cannot currently see.
And you cannot trace it to a cause.
Most multi-site surgical practices run on systems that do not talk to each other. Prexisio connects them — resolving patient identity, procedure records, and payment data into a single view — and shows you exactly where your surgical revenue is being lost.
Revenue loss by specialty — what the data shows
Primary revenue driver at this practice
25% cancellation rate
Estimated monthly revenue impact
$120K / month
400 cases × 25% × $1,200 avg — before OR idle time and payer underpayments
Calculate the number for your practiceConservative estimates based on specialty-specific averages. The actual number for your practice requires your data — which is what the assessment surfaces.
The data that would answer the question exists.It is just in three systems that have never been connected.
Multi-site specialty surgical practices run on an EMR, an ASC platform, and a billing system — each with different patient IDs for the same person. The questions leadership is asking require data that spans all three. Nobody has built that layer. So the questions go unanswered.
- Your cancellation rate is a number. When leadership asks which locations are driving it and why, the honest answer is that nobody can fully explain it from the data.
- Prior authorization denials are causing 48-hour cancellations. You know this is happening. You do not know which payers, which procedures, or how much it is costing — because nobody has connected the auth records to the surgical schedule.
- You have three locations performing at different levels. The data to explain the gap exists across your scheduling system, your ASC platform, and your billing records. It has never been connected.
What it looks like when it is fixed
A multi-site pain management group reduced their surgical cancellation rate from 30% to under 12% after Prexisio decomposed the root cause by location, referral source, and prior auth status. The fix was targeted — not organization-wide — because the data showed exactly where to act.
- Your payer contracts are PDFs sitting with legal. Nobody has compared what the contracts say you are owed against what actually arrived in the bank. That gap has been accumulating quietly for years.
- A payer sent a recoupment demand. The exposure exists because the reconciliation was never built. The data to defend the position — and recover what is owed — is in your billing system. Nobody has run it.
- The CFO asks for a clean view of revenue by location, by payer, by CPT code. The answer requires pulling from three systems that assign different patient IDs to the same person. That report has never been produced.
What it looks like when it is fixed
A PE-backed GI group had never reconciled their payer contracts against actual payments. When Prexisio digitized the contracts and ran the reconciliation, the underpayment gap across three payers exceeded $2M in recoverable revenue the organization had no visibility into.
Both problems have the same cause.
The scheduling system does not know what the billing system knows. The ASC platform does not know what the EMR scheduled. The billing system cannot see the prior auth timeline.
Prexisio builds the connective layer none of them provide — and delivers the answers your systems were never designed to give you.
The questions your data should be answering right now.
These are not hypothetical questions. They are the decisions your leadership team is trying to make every month. If your systems cannot answer them, that is not a gap in effort — it is a gap in infrastructure.
What is your cancellation rate by location — and which referral sources are driving it?
If your team can give you the rate but not the breakdown by cause, the diagnostic infrastructure does not exist yet. The number is visible. The explanation is not.
Deliverable D1 + D2Of every surgery you scheduled last month, how many were actually performed — and where did the rest go?
Most practices cannot answer this with precision. Rescheduled, cancelled, and no-showed cases each have different causes and different fixes. If they look the same in your data, the funnel has never been built.
Deliverable D1Which surgeries scheduled in the next 30 days are at risk of cancellation because prior authorization has not been confirmed?
If this list does not exist in your organization right now — updated weekly, mapped to the surgical schedule — you are managing prior auth reactively. The 48-hour cancellation is the most preventable and the most expensive.
Deliverable D3Are your payers paying what your contracts say they owe — and if not, how much is the gap?
The honest answer at most multi-site specialty practices is: we do not know, because the contracts are in PDFs with legal and nobody has compared them against what arrived. That gap has been accumulating quietly.
Deliverable D7Prexisio has eight diagnostic deliverables — each one built to answer a specific question your current systems cannot answer on their own.
See all eight deliverablesYour current vendors address the outcome.None of them diagnose the cause.
Every tool and vendor your practice already uses serves a real purpose. The gap is not in what they do — it is in the layer between your data and the decisions that depend on it. That layer does not exist inside any single system. Prexisio builds it.
Only Prexisio does all of this
- Surgical cancellation diagnostic decomposed by window, location, referral source, payer, and prior auth status
- Cross-system patient identity resolution — one patient record across your EMR, ASC platform, and billing system
- Prior auth risk mapped forward against your actual surgical schedule — updated weekly
- Payer contract vs. paid reconciliation — contracted amounts compared to what actually arrived
- Multi-location benchmarking — your best-performing location becomes the standard for all others
- Quantified dollar amount attached to every finding — not insights, a number
RCM Vendors
Process claims, manage collections, chase denials.
They fix the billing after it goes wrong. They do not diagnose why your cancellation rate is 28% or which referral sources are driving it.
EHR Analytics
Reporting within your EMR — appointments, encounters, patient records.
Single-system view only. Your EMR does not know what your ASC platform recorded or what your billing system collected. Cross-system analysis requires a connection that does not exist inside the EMR.
Scheduling Software
Reminders, waitlists, patient communication tools.
Reduces no-shows at the margin. Cannot tell you that prior auth lag with one specific payer is the real driver of your 48-hour cancellations — because it cannot see the auth records or the billing data.
Management Consultants
High-level strategy, process recommendations, organizational design.
Can diagnose at a strategic level but do not work in your data. They deliver a report. They do not build the patient identity bridge, run the SQL, or deliver a quantified dollar amount from your actual records.
Where Prexisio sits
High diagnostic depth. Built specifically for specialty surgical practices. No one else is here.
Every other option is either generic across industries or shallow in diagnostic depth. Prexisio is the only firm that connects your systems, resolves your patient identity problem, and delivers a quantified answer — built exclusively for multi-site pain management, GI, spine, and orthopedic practices.
Management Consultants
High-level strategy, generic industries, no recurring data delivery
PREXISIO
Deep diagnostic, specialty-specific, quantified monthly intelligence
RCM Vendors
Claims processing, billing, collections — outcome layer only
EHR Analytics
Single-system reporting, cannot cross-connect EMR + ASC + billing
The blank space in the top-right quadrant is where Prexisio operates. It is empty because nobody built the cross-system diagnostic capability for specialty surgical before.
See what we diagnoseFrom first conversation to full visibility.
Most organizations wait months for analytical work to produce anything useful. The first Prexisio findings land in front of your leadership team within 30 days of data access.
The Diagnostic Assessment
A focused conversation where we ask the eleven questions that reveal whether your practice has recoverable revenue sitting in your data. You leave with a specific dollar estimate — not a range, not a benchmark. The number for your organization.
No pitch. No demo. If we do not see a clear opportunity we will tell you.
Data Access and Foundation
We connect to your systems — Integy, HST Pathways, billing — and build the patient identity bridge that maps the same patient across every platform. We verify every field name and filter value before running a single production query.
Your data never leaves your environment. We work with read-only access inside your infrastructure.
The Diagnostic Sprint
We run the full analysis — cancellation decomposition by location and referral source, prior auth risk mapping, patient flow bottlenecks, OR utilization, and revenue integrity. You get findings, dollar amounts, and three prioritized interventions.
The findings presentation goes to your COO, CFO, and CEO. Every number is sourced to the query that produced it.
Ongoing Intelligence
Every diagnostic module refreshed with current data and delivered by the 10th of each month. Biweekly advisory calls. Quarterly strategic review. The intelligence layer your organization has never had — connected to last month's decisions every time.
You own the system. We stay responsible for what it produces. A departure is an HR event, not a reporting crisis.
The assessment is where it starts.
Forty-five minutes. Eleven questions. One specific dollar amount. If we do not see a clear opportunity in your data, we will tell you before you commit to anything.
Specialty-specific.Not one size fits all.
Every diagnostic playbook is built from operational experience inside real specialty surgical organizations. The questions we ask, the data tables we query, the fields we verify, and the benchmarks we measure against are calibrated to your specialty — not adapted from a generic healthcare template.
Different systems
A pain management group runs Integy and HST. A GI practice runs ModMed. The patient identity resolution logic, field names, and filter values are different. Generic code does not work.
Different cancellation drivers
In pain management, prior auth is the #1 cause. In GI, it is patient prep failure. In orthopedics, it is implant availability. The diagnostic has to know the difference.
Different benchmarks
A 15% cancellation rate in spine surgery means something different from 15% in colonoscopy scheduling. Benchmarks without specialty context are noise.
Pain Management
Common systems: Integy · HST Pathways · ModMed
- Prior auth as the #1 driver of 48-hour cancellations
- Scheduled-to-perform funnel across clinic and ASC locations
- Referral source quality — volume vs. net revenue per case
- Spinal cord stimulator and implant procedure tracking
Gastroenterology
Common systems: ModMed · AdvancedMD · Nextech
- ASC throughput and endoscopy case stacking optimization
- Colonoscopy scheduling cancellation decomposition
- PE consolidation — multiple systems unified under one view
- Payer mix optimization across acquired GI practices
Spine Surgery
Common systems: HST Pathways · Nextech · Epic
- OR utilization — first case starts and turnover time variance
- Complex case scheduling and block time management
- Implant cost tracking against billed and reimbursed amounts
- Multi-surgeon performance benchmarking by location
Orthopedics
Common systems: Modernizing Medicine · HST · Various
- Block scheduling utilization and surgeon access management
- Joint replacement ASC migration volume and outcome tracking
- Referral source intelligence for sports medicine pipeline
- Implant cost variance analysis by procedure and payer
Not sure where to start? Tell us about your practice and we will tell you where the highest-value diagnostic begins.
Proof of work
Organizations that no longer guess where their revenue is going.
Two engagements. Two specialties. The same root problem — systems that do not communicate and a data layer nobody had built.
30% surgical cancellation rate. COO stopped everything and pointed one person at the problem.
A multi-site pain management organization had no data infrastructure when the engagement began. Scheduling lived in Integy. Surgical records were in HST. Lab data was in Telcor. The same patient had a different ID in each system. Nobody had ever connected them.
In June 2019, the COO halted all other analytical work and directed everything toward one question: why is our surgical cancellation rate at 30%, and how do we get it under 10%?
Prexisio built the patient identity bridge across all three systems, constructed the scheduled-to-perform funnel from scratch, and decomposed every cancellation by window (48-hour, 24-hour, date-of-service), location, referral source, payer, and prior authorization status. For the first time, leadership could see not just the rate — but the cause.
Revenue integrity work followed: Prexisio compared billed amounts against contracted allowed amounts across all active payer contracts — which existed only as PDFs with legal and had never been reconciled against actual payments. The underpayment gap, when surfaced, exceeded $2M in recoverable revenue the organization had no visibility into.
30%
Cancellation rate at engagement start
<10%
COO target — achieved through root cause decomposition
$2M+
Underpayment gap identified in payer contract reconciliation
Gastroenterology · PE-Backed · MSOMultiple acquired GI practices. Different systems. Leadership asking for reporting that did not exist.
PE GI Solutions was a management services organization that had acquired multiple gastroenterology practices across different markets. Each practice came in with its own systems, its own patient records, its own payer contracts, and its own operational processes.
The PE ownership needed unified reporting across all acquired practices — AR aging, monthly billing performance, and payer mix — delivered on a recurring schedule. None of it existed in a single place. The data was there. The connection was not.
Prexisio built the integration layer across all acquired practices, delivered three recurring monthly reports without manual assembly, and managed the annual MIPS submission across the organization. The engagement ran through the full operating period until PE GI Solutions was acquired by SCA Health, a subsidiary of Optum.
3
Recurring monthly reports delivered on schedule every cycle
Multi
Acquired GI practices unified under one reporting layer
Annual
MIPS submission managed across the full organization
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Find out what your practice is leaving on the table.One call. One number. No obligation.
Forty-five minutes. Eleven diagnostic questions calibrated to your specialty. A specific monthly dollar amount from your actual data — whether the primary driver is your cancellation rate, OR utilization, block scheduling, or throughput. If we do not see a clear opportunity, we will tell you that too.
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