I help US healthcare practices find and recover money that automation misses — underpayments, denial patterns, and compliance gaps hiding inside paid claims.
Start with a Free Revenue Snapshot →"Most practices don't have a denial problem. They have a prevention problem."
Abhishek Kumar — Revenue Integrity ConsultantMapping denials back to broken workflows and fixing the source — not just appealing claims after the fact.
Auditing paid claims against contracts to uncover silent leakage. The money that technically got paid — just paid wrong.
Supporting SNF, Home Health, and Behavioral Health providers through CMS enrollment, survey readiness, and audit preparation.
Systematic follow-up on aging AR buckets — identifying what is recoverable, why it aged, and how to prevent recurrence.
Tracking payer-specific denial and underpayment patterns across Medicare, Medicaid, Medicare Advantage, and commercial plans.
Building denial dashboards, clean claim rate analysis, and payer behavior reports using Excel and SQL-based analysis.
CMS 855A, 855B, CAQH, PECOS, NPPES. Provider enrollment, re-credentialing, and expirables management.
A podiatry practice was losing hundreds of claims for bilateral heel spur removals (CPT 28119) with repeated "Invalid Modifier" denials. After pulling every operative note and reviewing the payer's bilateral surgery policy, I identified the mismatch: the payer required Modifier 50 for bilateral symmetrical procedures, not LT/RT separately. One line change. 100% of denied claims paid. $100,000+ recovered.
A behavioral health practice had a 96% net collection rate. Looked great. But when I compared their actual payments against their contracted rates line by line, I found $47,000 in underpayments over 12 months. The payer was applying the wrong fee schedule. No denial. No alert. Just quiet leakage.
A hospital system had no idea they were being underpaid. I audited 26 months of claims. The result? $340,000 in accumulated underpayments. The practice had no idea the money was missing.
A Florida podiatry practice received hundreds of denials from Oscar Health for "provider not registered." The provider was registered. After escalating to a supervisor, the admission came: "There is a system glitch on our end." Result: Over $100,000 recovered from claims that had been wrongly denied for months.
Mental health, SUD, and outpatient BH practices dealing with MA denials, underpayments, and recurring authorization issues.
HHAs navigating CMS 855A enrollment, survey readiness, compliance documentation, and Conditions of Participation.
SNFs dealing with Medicare and MA billing complexity, ADR preparation, and audit-ready documentation workflows.
Physician groups and hospital-based practices across primary care, surgery, emergency, and ancillary services needing RCM oversight.
"Abhishek helped us navigate the entire CMS enrollment process for our home health agency in Ohio. From 855A submission to policy development and survey readiness, he was thorough, responsive, and genuinely cared about getting it right. We are now actively billing Medicare. I would recommend him to any home health agency needing enrollment or compliance support."
— Chase Medical Services, Ohio
Start with a 15-minute Revenue Snapshot. Share one denial pattern or one aging AR bucket. I'll tell you whether it's recoverable, why it's happening, and one thing you can fix this week. No contract. No commitment.