Sentinel Clinical Risk Group LLC

Know your risk
before they do.

Independent specialist audits that identify liability exposure, recover missed reimbursement, and deliver a complete risk picture in 72 hours — from an RN, BSN, JD, MBA who built the methodology.

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30
Charts per provider reviewed
72h
Turnaround from chart receipt
3
Deliverables per engagement
2x
Risk identified & revenue recovered
Serving
Primary Care
Cardiology
Gastroenterology
Pain Management
Orthopedics
Urgent Care
EMR compliance ≠ audit defense
RAC audits look back 3 years
Undercoding costs practices $30K–$80K/year
E/M upcoding is a top OIG target
Copy-forward = recoupment risk
Most practices have never had independent review
Michigan MAC audit activity is increasing
The Problem — And The Opportunity

Your EMR doesn't
protect you — or pay you.

Most independent practices operate under the assumption that a clean claim is a safe claim. It isn't. EMRs are designed to capture data and streamline workflow — not to evaluate whether your documentation would withstand a payer audit, a RAC review, or a medical necessity challenge. That gap is where your exposure lives.


The same documentation habits that create audit risk also leave money on the table. Undercoding is endemic across specialties — physicians routinely bill below what the documentation supports. A Sentinel audit finds both problems simultaneously: the liability you didn't know you had, and the reimbursement you weren't collecting.

The Auto-Population Trap
Template-driven and copy-forward documentation routinely fails to support the E/M level billed. EMR compliance alerts check for required fields — not documentation quality.
Invisible Audit Triggers
RAC, MAC, and commercial payer algorithms flag practices based on billing pattern anomalies — data the practice never sees until an audit request arrives.
Retroactive, Compounding Risk
A single audit covering 24 months of claims can generate six-figure recoupment demands with no advance warning. The cost of discovery is always higher than the cost of prevention.
The Undercoding Revenue Gap
Systematic undercoding costs a 3-physician practice $30,000–$80,000 in recoverable annual revenue. Sentinel identifies both directions of exposure — the liability and the missed reimbursement — in a single engagement.
The Process

From engagement to
report in 72 hours.

A structured five-step process designed to deliver a clear, actionable risk picture with minimal disruption to your practice.

01
Engagement
Execute MSA and SOW. Confirm provider count and 30-chart sample scope.
02
Chart Access
Practice provides HIPAA-authorized chart access. Sentinel executes BAA.
03
Clinical Audit
Charts reviewed against E/M guidelines, payer LCD criteria, and documentation standards.
04
Report Delivery
Full deliverable package returned within 72 hours of receiving complete chart access.
05
Debrief
Optional 30-minute walkthrough to review findings and answer provider questions.
What You Receive

Three deliverables.
One clear picture.

Sentinel Clinical Risk Score
A single numeric score benchmarking your practice's overall documentation risk exposure. Comparable across providers, trackable over time, and designed to communicate risk severity in language that resonates with physicians and practice managers alike.
7.2
Sample Risk Score
Moderate–High Exposure
🗺
Provider Risk Heat Map
Visual breakdown by provider, code range, and documentation category — showing exactly where the highest-risk patterns are concentrated so remediation can be prioritized immediately.
📋
Audit Findings Report
Chart-level findings with specific documentation deficiencies, billing support gaps, and medical necessity concerns identified in plain, actionable language — not boilerplate compliance jargon.
✦
Corrective Action Plan
A streamlined, one-page-per-provider action plan. Three to five ranked changes written in clinical language — not compliance jargon. Readable in five minutes, implementable by Monday. No outside counsel required.
Andrew Foley
RN, BSN  ·  JD  ·  MBA

Andrew brings an uncommon combination of clinical bedside experience, legal analytical training, and healthcare business acumen to every engagement. Sentinel's findings are defensible and clinically grounded — informed by real-world understanding of how physicians document, how payers audit, and what the gap between the two costs practices.

Registered Nurse, BSN Juris Doctor MBA Michigan-Based HIPAA Compliant
01
Clinical + Legal + Business
Most compliance reviewers come from one background. Sentinel brings three — clinical credibility, legal analytical rigor, and operational business judgment in a single engagement.
02
Genuinely Independent
No EMR vendor relationship, no coding upsell, no software to license. Sentinel's only product is an honest assessment of your documentation — both the risk you carry and the revenue you're leaving behind.
03
Built for Independent Specialists
Not a generic compliance firm. The methodology is purpose-built for independent primary care, cardiology, gastroenterology, pain management, and urgent care — the E/M complexity, procedure coding, and payer patterns that define each specialty.
04
Risk Protection + Revenue Recovery
Most audits only look for what you're doing wrong. Sentinel looks in both directions — identifying audit liability and systematically undercoded visits that represent recoverable revenue at no additional cost.
05
72-Hour Turnaround
Faster than any internal review process. You know where you stand — and what you're owed — before the next billing cycle.
Services

Two ways to work
with Sentinel.

All fees are set per engagement in a Statement of Work tailored to your practice. Contact us to discuss scope and pricing.

One-Time
Clinical Documentation Audit
A comprehensive, independent review of your practice's documentation — delivered in 72 hours. Priced per physician based on practice size and scope.
  • ✦30-chart review per physician
  • ✦Sentinel Clinical Risk Score
  • ✦Provider risk heat map
  • ✦Audit findings report
  • ✦Corrective action plan
  • ✦72-hour delivery
  • ✦Optional 30-min provider debrief
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Monthly
Practice Revenue Intelligence
Monthly documentation performance review that tracks reimbursement recovery, identifies new undercoding patterns, and maintains the documentation discipline established in your initial audit. Priced per physician per month.
  • ✦20-chart monthly review per physician
  • ✦Updated Sentinel Risk Score each cycle
  • ✦Month-over-month revenue trend tracking
  • ✦Revenue intelligence report with ranked action items
  • ✦Priority turnaround
  • ✦6-month initial commitment
Learn More
All engagements governed by MSA + Statement of Work  ·  HIPAA BAA executed prior to chart access  ·  No retainer required to start
Common Questions

What practices
ask us first.

We've never had an audit. Why do we need this?
That's the most common thing we hear from practices right before they receive one. Audits don't send advance notice — they arrive as demand letters. A 30-chart review costs a fraction of what a single recoupment demand will.
Our biller handles compliance. Isn't that enough?
Billers optimize for clean claims submission — that's different from evaluating whether the underlying documentation supports the code billed. Sentinel looks at what a payer auditor would see, not what a clearinghouse accepts.
Our EMR flags compliance issues. Doesn't that protect us?
EMR alerts check for required fields — they don't evaluate documentation quality or whether the clinical picture supports medical necessity. They're a workflow tool, not an audit defense.
What happens to our patient data?
Sentinel executes a HIPAA Business Associate Agreement before receiving any patient records. All PHI is handled in accordance with HIPAA Privacy and Security Rule requirements. Charts are reviewed and then returned or destroyed per the BAA terms.
We already had a compliance review done.
When was it? Documentation risk evolves with every payer policy update and provider habit. Most practices benefit from an independent review every 12–18 months — and a prior review doesn't reflect your current exposure.
Is this legal advice?
No. Sentinel provides healthcare compliance consulting and clinical documentation risk assessment services. Our reports are informational and analytical in nature. No attorney-client relationship is created. Practices with specific legal compliance questions are encouraged to consult qualified legal counsel.
Get Started

Protect your practice.
Recover your revenue.

A 30-chart audit identifies both your audit liability and your missed reimbursement — delivered in 72 hours with a streamlined action plan you can implement immediately. No long-term commitment required to start.

Request an Audit Or call to discuss