The money arrived with conditions. The conditions outlive the money.
This is what we would actually do, in what order, and what it costs.
No discovery call is required to see the number.
What we would go looking for
These are patterns that recur in a human services organization, written as things to
look for. They are not findings from a named engagement.
Service units delivered, units billed and units authorized described by three different numbers, with nobody owning the distance between them.
A cost allocation plan approved years ago and applied by habit since, so indirect recovery drifts from what the plan actually permits.
Medicaid recoupments after payment — for eligibility that lapsed, supervision that was not documented, or a service note that did not meet the standard — absorbed as bad debt rather than traced to the process that caused them.
Agency and overtime cover for vacancies, priced into no program budget, quietly turning a funded program into a subsidized one.
Programs cross-subsidizing each other invisibly, because the true cost of each is never assembled and the board sees only the consolidated position.
The sequence
Five weeks for one operating unit. More units run in parallel rather than in
series, so a group does not take five times as long.
Week 1
Intake and reconciliation8 requests written for a human services organization, alongside the 107 covering the operating spine. We tell you which findings the gaps will limit before any fieldwork starts.
Weeks 2–3
Full pass, not a sampleEvery unit of service in scope is read rather than sampled.
Week 4
Quantification and challengeEach finding sized, and put to whoever owns it before it is written down.
Week 5
Report and walkthroughThe written report, ranked by annual value and by how hard each finding is to act on.
5 core requests written for a human services organization, inside the full intake.
Anything you do not have can be skipped with a reason — skipping narrows what the
review can conclude, and we tell you where before the work starts rather than after.
Funding sources: contracts, grants and rate agreements — Per funder, with period, ceiling and the reporting each requires.
Cost allocation plan and indirect rate agreement — The approved plan, and how it is actually applied month to month.
Service units delivered against units billed and units authorized — Three numbers that describe the same service; the gaps are the finding.
Medicaid denials and recoupments, by reason — Including anything recouped after payment.
Staff credentialling and supervision records — A service delivered by an unqualified or unsupervised staff member is unbillable retroactively.
If any of this is already happening
The review is always worth doing and rarely urgent. It becomes urgent when
something else is happening — and if one of these is, the sequence above compresses
to fit it.
A recoupment demand after a state audit
A rate rebase or a contract renewal at a rate that no longer covers staffing
A single audit finding, especially a repeat one
A merger conversation with another provider
Losing a funder and discovering which shared costs it was carrying
Who needs to be in the room
Signs it: Executive director or CFO
Will resist it: Program directors whose individual program economics become visible — worth telling them what the
review is for before they hear it from somewhere else.
Has been asking for it: The finance team, who already suspect which programs are subsidized
What it costs
Priced by operating unit — an entity, a location, or a business the accounts are
kept separately for. The second unit costs less than the first because by then the
intake is built, the chart of accounts is understood and the patterns are known.
Purchase order is the primary route — most
buyers this size raise a PO and pay against an invoice on terms. Card and bank
transfer exist for those who prefer them.