In the last 12 months, the MDaudit Community has successfully retained over $100 million in revenue by leveraging technology and analytics to build a strong line of defense against payer scrutiny.
If your organization wants to protect revenue, reduce takebacks, and improve audit response times, these are the essential technologies you need to implement:
Building a Strong Line of Defense with eMDR, esMD, and AI
eMDR: Front-End Visibility for Medicare and Medicare Contractors
The Electronic Medical Documentation Request (eMDR) system enhances visibility and efficiency when handling Medicare and Medicare contractor audits. It allows organizations to:
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Electronically receive Additional Documentation Requests (ADRs) from Medicare Administrative Contractors (MACs) and other payers.
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Seamlessly create an audit post-receipt to optimize response times for the requestor.
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Improve operational efficiency, ensuring all deadlines are met and reducing the risk of revenue loss.
Learn more payer audit management
AI & Analytics: The Middle Layer for Revenue Retention
AI-driven technologies like Smartscan.ai automatically analyze commercial payer ADRs, helping compliance teams:
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Extract key request data, match it with claims and remittance records, and identify the highest-value claims for appeal.
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Eliminate manual data entry, saving valuable time for audit and compliance teams.
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Improve overall payer audit success rates by ensuring the most impactful claims are addressed first.
esMD: A Back-End Defender for Payer Audits
The Electronic Submission of Medical Documentation (esMD) system is critical for handling external payer requests efficiently. It:
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Streamlines electronic submissions of medical records and appeal documentation.
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Ensures timely communication with requestors, reducing delays and minimizing takebacks.
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Enhances audit tracking and compliance by maintaining a structured, automated response process.
Centralized Document Management: The Foundation for Compliance
A Document Management System is essential for tracking and securing all payer audit communications. It:
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Stores all submitted and received documentation in a centralized, secure repository.
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Enhances collaboration across revenue cycle, compliance, and audit teams.
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Ensures easy access to payer correspondence, reducing response delays and improving compliance.
Process Templates: Automating Task Management for Compliance
Automated process templates guide billing compliance, revenue cycle, and revenue integrity teams through best practices for responding to external payers and contractors. These templates:
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Improve efficiency and consistency in audit response workflows.
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Ensure compliance with payer audit protocols and deadlines.
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Reduce administrative burdens and allow teams to focus on higher-value revenue recovery activities.
Watch the Full Webinar: Strengthen Your Defense Against Payer Scrutiny
Want to learn more? Watch our exclusive webinar:
How to Combat Payer Scrutiny with AI, eMDR & esMD
This session covers real-world strategies and technology-driven solutions that leading healthcare organizations use to defend revenue and optimize compliance.
