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Charge capture audit

LLM review of notes vs CPT/HCPCS codes to recover missed charges.

INTERNAL FORENSICS · CHARGE CAPTURE AUDIT · VOL. XXVII

Notebook of Recovered Charges

Auditor: M. Whitfield, CPC-A · Period · 04/01–04/30/2026
EVIDENCE
DO NOT REMOVE
Notes scanned
2,184
last 30 days
fol. 13
Findings flagged
128
87 pending
fol. 16
Recovered MTD
$2191
accepted findings
fol. 13
Potential pending
$5292
if all accepted
fol. 17
✎ DOCKET · PROVIDERS UNDER REVIEW
fol. 1–20 of 87
✎ EXHIBIT · ENC-44543
2026-04-22

Dashiell Marquardt

attending: Dr. T. Nakagawa

LLM evidence

"...audiometry performed bilateral, normal..."

FINDING
92551Pure-tone audiometry screening
+$15.72 est.·74% confidence
✎ CHAIN OF CUSTODY
  • ① Encounter note · FHIR DocumentReference/ENC-44543
  • ② Original charge slip · 1 CPT submitted
  • ③ Payer fee schedule · Medicare Part B 2026.1
  • ④ NCCI / MUE edit results · clean
signed · M. Whitfield04/30/26 · 11:42
··· end of folio · synthetic exhibits, no PHI · JetBridge AI ···

RCM · Charge integrity

Missed-charge recovery dashboard

Where the LLM auditor is finding leakage and how much it's adding back.

Synthetic data

Top missed CPT codes

  • 99354Prolonged service, +30 min$148/ea · 84
  • 96372Therapeutic injection$28/ea · 62
  • G0444Annual depression screen$18/ea · 211
  • 94760Pulse oximetry$5/ea · 318
  • 20610Joint injection, major$92/ea · 22

Revenue recovery trend

Weekly $ recovered

Sparkline

Connectors used

Eligibility & Claims

required

Stedi / Availity

Confirm payer rules before claim drop

Microsoft Excel

required

Variance worklist for coders

Snowflake / BigQuery / Databricks

optional

Recovered-revenue analytics

Clinical Terminology

optional

RxNorm, ICD-10, SNOMED, LOINC, OpenFDA, ClinicalTrials.gov

CPT/HCPCS validation