Revenue Integrity Diligence: What Every PE Sponsor Should Assess Before Signing a Specialty Care Deal
Most diligence processes assess revenue cycle at the surface level. This guide covers the questions that reveal whether reported collections will hold post-close, and what the RCM infrastructure will actually cost to bring up to standard.
Why revenue cycle diligence is different from financial diligence
A specialty care deal can look clean on the income statement and carry significant hidden risk in the revenue cycle. Collection rates that look strong may be masking denial write-offs that never hit the P&L. Clean claims rates may reflect a billing team working around system limitations rather than a platform catching errors upstream. Days in AR may be trending the right direction for the wrong reasons.
The questions most sponsors don't ask in diligence are the ones that show up in the first two quarters post-close.
The revenue cycle is where reported performance either holds or unravels after close. Getting the diligence right means understanding not just what the numbers say, but what the infrastructure behind them can sustain.
What the guide covers
The six areas of revenue cycle risk
The risk areas most diligence processes underweight, and the specific questions to ask in each one.
How to read collection rate and AR data
Separating genuine operational performance from timing effects and write-off patterns.
What RCM infrastructure signals
Post-close integration cost, staff dependency risk, and the realistic timeline to performance improvement.
Audit exposure questions
Essential given the OIG's ongoing specialty care audit series, including how to assess whether historical claims documentation holds up to scrutiny.
A framework for scoring RCM readiness
So diligence findings translate into a consistent view of risk and post-close priority across your portfolio.
Download the guide
Built for PE operating partners and deal teams evaluating specialty care acquisitions. No form required.