Outsource vs In-House

Delays in SOC can result in lost referrals, missed episode revenue, and increased LUPA risk.

Example:
3 delayed or lost referrals per month
× $2,500 average reimbursement
= $7,500 monthly loss
= $90,000 annually

Timely intake, authorization, and scheduling protect this revenue.

Unsigned physician orders are one of the most common causes of delayed claims.

Example:
10 charts on hold × $2,500 average claim
= $25,000 in delayed cash flow

Consistent order tracking and follow-up prevents claims from sitting in billing hold.

Late or incomplete prior authorizations can lead to denied visits or non-billable services.

Example:
5 denied managed care episodes × $3,000
= $15,000 lost revenue

Active authorization tracking reduces denial risk and protects reimbursement.

Improper visit frequency scheduling increases LUPA risk.

Example:
4 LUPA episodes per month
× $1,200 average revenue reduction
= $4,800 monthly loss
= $57,600 annually

Scheduling aligned with ordered frequency helps maintain full episode reimbursement

Referral sources monitor SOC timeliness and communication.

Losing just one referral source can equal
$20,000–$100,000+ annually in lost census potential.

Reliable operations protect long-term referral growth.