AI-Powered Technology for Continuous Risk Monitoring (CRM)
Boost Productivity, Operational Efficiency, and Enhance Revenue Margins
MDaudit’s AI-driven platform drives billing, coding, and revenue outcomes by unlocking access to deeper, more meaningful insights that will help drive your programs to the next level. With these capabilities, you can ensure you are billing compliantly and retaining your hard-earned revenues via data-driven decision-making and automation. MDaudit believes AI should always involve humans ‘in the loop’, fostering a healthy partnership between technology and people.
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MDaudit’s AI Capabilities include:
Generative AI
MDaudit’s Insights.ai enables users to easily interact with very complex billing data – simply by asking questions in plain English – there is no need to know how to write advanced technical queries.
- Receive real-time insights within claims data, denials data and audit data in order to make timely operational, strategic and financial decisions
- Easily identify your most at-risk providers, coders, highrisk DRGs and systemic denial patterns
- Efficiently drill-down to root cause of billing anomalies and high-dollar claims denials
- Insights delivered are tightly integrated with actionable workflows to drive positive outcomes
Anomaly Detection
Located within Audit Insights and Revenue Optimizer, MDaudit’s Change Analysis uses AI to interrogate anomalies in billing and denial data, providing immediate insights into the root cause.
- Ability to utilize AI to interrogate voluminous amounts of 835 remittance data to immediately understand root-cause of systemic denial patterns
- Easily identify risk, maximize revenues and make strategic financial decisions from actionable insights at your fingertips
Smart Scan Functionality
Integrated into MDaudit’s External Audit Workflow module, SmartScan.ai leverages AI technology to optimize your response times back to external auditors (e.g., RAC, MAC, TPE, UPIC, SMRC and more).
- Easily scan payer request letters (ADRs) for the automated loading of all pertinent account data
- Drastically mitigate manual entry and reconciliation of demand letter data
- Conduct audits rapidly and retain revenues quickly
- Ensure tight deadlines are met to maximize dollars retained and reduce dollars refunded
- Works for both professional and hospital claims as well as for all payors
MDaudit's AI Vision
The innovations in AI have ramped up increasingly in the last 12 months and Generative AI has really opened possibilities of this being the next best technology innovation by humans after the internet, according to Bill Gates.
