# DenQAI: payer participation scenarios

File-specific companion · 2026-09-10

## Purpose

How do one practice’s participation options affect patient access, cash, workload, and transition needs?

**Who:** Practice owner, billing lead, and independent contract reviewer

**Records:** Aggregate visits, expected receipts, administrative time, reserve need, and reviewed contract/notice facts.

## Complete the file

1. Complete each relevant scenario using the same monthly period and coded relationship.
2. Enter visits, bank cash, administration hours, one-time cash need, and transition weeks separately.
3. Describe patient_access_effect, open contract questions, and evidence_status before comparing the options.

## Definitions

- **Expected bank cash per month:** Modeled receipts for the stated month, not billed charges.
- **One-time transition cash need:** Additional cash required during the modeled change.
- **Evidence status:** Whether the supporting records have been requested, received, or reviewed.

## Fictional example

Fictional example: Remain participating preserves 120 visits per month with 18 administrative hours; a second scenario has unknown notice weeks, so that comparison remains incomplete.

## Review and next action

Investigate the uncertain input that could change the practice’s individual decision.

The CSV does not rank payers, calculate a recommended choice, or authorize coordinated participation decisions.

[Related DenQAI guide](https://denqai.com/insurance)

## AI coach prompt

Help me use DenQAI’s payer participation scenarios. My question is: How do one practice’s participation options affect patient access, cash, workload, and transition needs? Explain these terms in plain language: Expected bank cash per month, One-time transition cash need, Evidence status. Ask one question at a time about the required records: Aggregate visits, expected receipts, administrative time, reserve need, and reviewed contract/notice facts. Walk through the supplied fictional example before asking me for inputs. Treat every missing value as unknown, not zero. Do not invent source records, contract terms, legal conclusions, or clinical facts. Use only permitted fictional or aggregate, non-identifying information. Follow this boundary: The CSV does not rank payers, calculate a recommended choice, or authorize coordinated participation decisions. End with the missing evidence and this next step: Investigate the uncertain input that could change the practice’s individual decision.

## AI review prompt

Review my permitted fictional or aggregate draft of DenQAI’s payer participation scenarios against the file instructions. Check each required field and period, units, evidence locator, assumptions, arithmetic where formulas are actually supplied, and unresolved contradictions. Check the sequence: Complete each relevant scenario using the same monthly period and coded relationship. Enter visits, bank cash, administration hours, one-time cash need, and transition weeks separately. Describe patient_access_effect, open contract questions, and evidence_status before comparing the options. Separate facts from assumptions and missing records. Do not supply unsupported numbers or make a professional decision for me. Apply this limitation: The CSV does not rank payers, calculate a recommended choice, or authorize coordinated participation decisions. Return corrections, questions for the responsible reviewer, and the next action.