Procedures · mix · Riverbend Veterinary Group

Columbus billed the brief exam code when the visit was complex — a charge-integrity gap, not a demand problem.

Feb urgent-care revenue = $583.4K; January and March averaged $655.4K, a $72.0K dip. Investigation: 26% of urgent-care exams in February (284 of 1,089) were billed under UC-EXAM-BRIEF ($79) when the visit complexity matched UC-EXAM-COMPLEX ($198). A Cornerstone template default changed on 2026-02-01. Downcoding under-bills charted care — the same revenue-integrity gap the charge-integrity view measures, here as a wrong code rather than a missing line. The recoverable portion is back-billable; the going-forward portion is one template fix.

Cleveland ER imaging share climbed 6% across the window.

Imaging moved from 19.7% of procedure revenue in 2025-10 to 20.9% in 2026-04. Total Cleveland procedure revenue in the window: $5.75M. The capital case for the CT lease is paying out. Operating question: does radiology staffing match the new throughput?

Riverbend Emergency Cleveland · by month

Imaging-share trajectory by month: 2025-10: 19.7% → 2025-11: 19.2% → 2025-12: 19.5% → 2026-01: 19.4% → 2026-02: 22.6% → 2026-03: 21.7% → 2026-04: 20.9%

Riverbend Urgent Care Columbus · by month

Feb 2026 dip is the mis-coding window. Jan $692.3K → Feb $583.4K → Mar $618.6K.

What this looks like in your stack today. A single-PMS analytics shop (BluWave, Reflexion) ships you monthly category PDFs per practice — no cross-site mix, no anomaly highlighting, no SQL you can audit. Vetspire requires a full PMS migration to even produce one of these charts. A from-scratch Looker build needs your data engineer to model the procedure-category dimension table, pivot by week / month, and ship the cross-site comparison — and that's before anyone audits whether the brief-vs-complex exam split looked off in February. The drawer in the lower-right shows the exact SQL we ran. Copy it, paste it into your own warehouse, see if your Feb dips too.

Cited benchmarks. Procedure prices are anchored to the AAHA Veterinary Fee Reference (11th ed.). Exam codes are practice-style invoice items mapped to the VMG/AAHA Chart of Accounts revenue categories (there is no "complexity band" construct in veterinary coding; that was a human-payer notion). The February downcoding rate in the seeded Columbus dataset (26%, shown in the third drawer query) is a Central Uplift construct for demo legibility; real-world Cornerstone template-default drift is documented across multiple practice-management forums in 2024-2025. The Cleveland imaging ramp is a modeled linear construct, not a benchmarked level. Press Q for the queries this page ran.

SQL · this page ran 3 queries Q to toggle

Cleveland procedure mix

SELECT
  (CAST(strftime('%s', strftime('%Y-%m-01 00:00:00', v.visit_date / 1000, 'unixepoch')) AS INTEGER) * 1000) AS bucket_start,
  p.category,
  SUM(p.revenue_cents) AS revenue_cents,
  COUNT(p.id) AS procedure_count
FROM procedures p
JOIN visits v ON v.id = p.visit_id
JOIN hospitals h ON h.id = v.hospital_id
WHERE v.visit_date >= 1759600167940 AND h.slug = 'rb-er-cle'
GROUP BY bucket_start, p.category
ORDER BY bucket_start, p.category

Columbus procedure mix

SELECT
  (CAST(strftime('%s', strftime('%Y-%m-01 00:00:00', v.visit_date / 1000, 'unixepoch')) AS INTEGER) * 1000) AS bucket_start,
  p.category,
  SUM(p.revenue_cents) AS revenue_cents,
  COUNT(p.id) AS procedure_count
FROM procedures p
JOIN visits v ON v.id = p.visit_id
JOIN hospitals h ON h.id = v.hospital_id
WHERE v.visit_date >= 1759600168039 AND h.slug = 'rb-uc-cmh'
GROUP BY bucket_start, p.category
ORDER BY bucket_start, p.category

Columbus February brief-vs-complex exam-code split (downcoding rate)

SELECT p.code, COUNT(*) AS n
FROM procedures p
JOIN visits v ON v.id = p.visit_id
JOIN hospitals h ON h.id = v.hospital_id
WHERE h.slug = 'rb-uc-cmh'
  AND p.code IN ('UC-EXAM-BRIEF', 'UC-EXAM-COMPLEX')
  AND strftime('%Y-%m', v.visit_date / 1000, 'unixepoch') = '2026-02'
GROUP BY p.code

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