One of the most impactful workstreams of the engagement was a systematic vendor audit — going invoice by invoice, line by line, reconciling billing portal data against invoices on file and against the executed Statement of Work. The goal was to identify what the organization was being charged for and whether each charge was contractually defensible.
Invoice vs. SOW
Line-by-line reconciliation
Every vendor invoice was reconciled against the executed Statement of Work — matching billable items to contractual definitions, billing portal records to invoices on file, and identifying any discrepancy between what was charged and what was owed.
Contract interpretation
Parsing what "billable" actually meant
The SOW defined a billable "Communication" as a document that was created, saved as an image, and delivered. Documents that were generated but never delivered to patients did not meet that definition — and charges for those documents were challenged directly.
Service credits identified
Three categories of recoverable charges
The audit identified overage charges on stricken and undelivered documents; a quality-failure credit for thousands of patient emails sent with the client's name misspelled; and CPI-based rate increases that had been applied without the written notice required under the contract.
Dispute resolution
Drafted and led the vendor correspondence
All written correspondence and escalation were drafted and led directly on behalf of the client — including follow-up letters with quantified disputed amounts, documentation of the contractual basis for each dispute, and coordination of resolution meetings with the vendor.
Medical vendors
Lab and anesthesia vendor audits
The audit scope extended beyond the primary vendor to cover medical vendors — including lab and anesthesia billing — reviewing charges against contracted rates and service documentation.
Revenue cycle
AR aging and collections reconciliation
AR aging was reviewed by payer — commercial insurers, self-pay, and cryo storage — alongside medical vendor audits and collections reconciliation to identify gaps and prioritize recovery actions.