{
  "deal_id": "390049",
  "run_id": "20260425T212058Z-76ccdd",
  "questions": [
    {
      "question": "Request 24 months of RCM scorecard data covering denial volumes, days in A/R, cash collections, and clean-claim rate. Include payer-split where available.",
      "trigger_metric": "completeness.coverage_pct",
      "trigger_reason": "Insufficient data for reliable analysis",
      "priority": "P0",
      "category": "DATA_QUALITY",
      "trigger": "Insufficient data for reliable analysis",
      "context": "Only 0% of required metrics are available (0/38). Core diligence conclusions need more data before they can be defended in IC."
    },
    {
      "question": "Please provide Initial Denial Rate data for the last 36 months. This metric has the #1 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "denial_rate",
      "trigger_reason": "missing Initial Denial Rate",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:denial_rate",
      "context": "Initial Denial Rate is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Net Days in A/R data for the last 36 months. This metric has the #2 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "days_in_ar",
      "trigger_reason": "missing Net Days in A/R",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:days_in_ar",
      "context": "Net Days in A/R is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Final Denial Write-off % data for the last 36 months. This metric has the #3 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "final_denial_rate",
      "trigger_reason": "missing Final Denial Write-off %",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:final_denial_rate",
      "context": "Final Denial Write-off % is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Net Collection Rate (Cash as % of NPSR) data for the last 36 months. This metric has the #4 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "net_collection_rate",
      "trigger_reason": "missing Net Collection Rate (Cash as % of NPSR)",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:net_collection_rate",
      "context": "Net Collection Rate (Cash as % of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "Please provide Cost to Collect (% of NPSR) data for the last 36 months. This metric has the #5 highest impact on EBITDA valuation among RCM KPIs.",
      "trigger_metric": "cost_to_collect",
      "trigger_reason": "missing Cost to Collect (% of NPSR)",
      "priority": "P0",
      "category": "OPERATIONAL",
      "trigger": "missing:cost_to_collect",
      "context": "Cost to Collect (% of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
    },
    {
      "question": "What is the current CDI program structure and staffing?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "CODING",
      "trigger": "standard",
      "context": "Most of our value-creation planning assumes a CDI program capable of lifting CMI by 0.05-0.10; need to know the baseline staffing."
    },
    {
      "question": "What EHR and billing system(s) are in use? Are there planned technology transitions?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "EHR transitions and billing-system migrations routinely disrupt cash for 2-3 quarters \u2014 the investment committee needs a heads-up."
    },
    {
      "question": "Are there any pending payer contract renegotiations or change-of-control provisions that could affect post-acquisition revenue?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P1",
      "category": "PAYER",
      "trigger": "standard",
      "context": "Change-of-control clauses can trigger rate renegotiation or termination rights \u2014 left undiscovered they destroy the underwriting case."
    },
    {
      "question": "Provide the charge description master (CDM) for review.",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P2",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "Outdated CDMs leak revenue on high-volume service lines. A clean CDM review is cheap and catches errors that the operator has stopped noticing."
    },
    {
      "question": "What is the IT contract portfolio (managed services, outsourced coding, clearinghouse agreements)?",
      "trigger_metric": null,
      "trigger_reason": "",
      "priority": "P2",
      "category": "OPERATIONAL",
      "trigger": "standard",
      "context": "Vendor lock-in on coding or clearinghouse agreements constrains the operational-improvement playbook; price the exit fees into the thesis."
    }
  ],
  "by_priority": {
    "P0": [
      {
        "question": "Request 24 months of RCM scorecard data covering denial volumes, days in A/R, cash collections, and clean-claim rate. Include payer-split where available.",
        "trigger_metric": "completeness.coverage_pct",
        "trigger_reason": "Insufficient data for reliable analysis",
        "priority": "P0",
        "category": "DATA_QUALITY",
        "trigger": "Insufficient data for reliable analysis",
        "context": "Only 0% of required metrics are available (0/38). Core diligence conclusions need more data before they can be defended in IC."
      },
      {
        "question": "Please provide Initial Denial Rate data for the last 36 months. This metric has the #1 highest impact on EBITDA valuation among RCM KPIs.",
        "trigger_metric": "denial_rate",
        "trigger_reason": "missing Initial Denial Rate",
        "priority": "P0",
        "category": "OPERATIONAL",
        "trigger": "missing:denial_rate",
        "context": "Initial Denial Rate is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
      },
      {
        "question": "Please provide Net Days in A/R data for the last 36 months. This metric has the #2 highest impact on EBITDA valuation among RCM KPIs.",
        "trigger_metric": "days_in_ar",
        "trigger_reason": "missing Net Days in A/R",
        "priority": "P0",
        "category": "OPERATIONAL",
        "trigger": "missing:days_in_ar",
        "context": "Net Days in A/R is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
      },
      {
        "question": "Please provide Final Denial Write-off % data for the last 36 months. This metric has the #3 highest impact on EBITDA valuation among RCM KPIs.",
        "trigger_metric": "final_denial_rate",
        "trigger_reason": "missing Final Denial Write-off %",
        "priority": "P0",
        "category": "OPERATIONAL",
        "trigger": "missing:final_denial_rate",
        "context": "Final Denial Write-off % is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
      },
      {
        "question": "Please provide Net Collection Rate (Cash as % of NPSR) data for the last 36 months. This metric has the #4 highest impact on EBITDA valuation among RCM KPIs.",
        "trigger_metric": "net_collection_rate",
        "trigger_reason": "missing Net Collection Rate (Cash as % of NPSR)",
        "priority": "P0",
        "category": "OPERATIONAL",
        "trigger": "missing:net_collection_rate",
        "context": "Net Collection Rate (Cash as % of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
      },
      {
        "question": "Please provide Cost to Collect (% of NPSR) data for the last 36 months. This metric has the #5 highest impact on EBITDA valuation among RCM KPIs.",
        "trigger_metric": "cost_to_collect",
        "trigger_reason": "missing Cost to Collect (% of NPSR)",
        "priority": "P0",
        "category": "OPERATIONAL",
        "trigger": "missing:cost_to_collect",
        "context": "Cost to Collect (% of NPSR) is unobserved; without it the regression layer falls back to benchmark P50 and the EBITDA bridge loses this lever."
      }
    ],
    "P1": [
      {
        "question": "What is the current CDI program structure and staffing?",
        "trigger_metric": null,
        "trigger_reason": "",
        "priority": "P1",
        "category": "CODING",
        "trigger": "standard",
        "context": "Most of our value-creation planning assumes a CDI program capable of lifting CMI by 0.05-0.10; need to know the baseline staffing."
      },
      {
        "question": "What EHR and billing system(s) are in use? Are there planned technology transitions?",
        "trigger_metric": null,
        "trigger_reason": "",
        "priority": "P1",
        "category": "OPERATIONAL",
        "trigger": "standard",
        "context": "EHR transitions and billing-system migrations routinely disrupt cash for 2-3 quarters \u2014 the investment committee needs a heads-up."
      },
      {
        "question": "Are there any pending payer contract renegotiations or change-of-control provisions that could affect post-acquisition revenue?",
        "trigger_metric": null,
        "trigger_reason": "",
        "priority": "P1",
        "category": "PAYER",
        "trigger": "standard",
        "context": "Change-of-control clauses can trigger rate renegotiation or termination rights \u2014 left undiscovered they destroy the underwriting case."
      }
    ],
    "P2": [
      {
        "question": "Provide the charge description master (CDM) for review.",
        "trigger_metric": null,
        "trigger_reason": "",
        "priority": "P2",
        "category": "OPERATIONAL",
        "trigger": "standard",
        "context": "Outdated CDMs leak revenue on high-volume service lines. A clean CDM review is cheap and catches errors that the operator has stopped noticing."
      },
      {
        "question": "What is the IT contract portfolio (managed services, outsourced coding, clearinghouse agreements)?",
        "trigger_metric": null,
        "trigger_reason": "",
        "priority": "P2",
        "category": "OPERATIONAL",
        "trigger": "standard",
        "context": "Vendor lock-in on coding or clearinghouse agreements constrains the operational-improvement playbook; price the exit fees into the thesis."
      }
    ]
  },
  "count": 11
}