Our CEO Ritesh Ramesh authored an article in HIT Consultant titled “Why Retrospective Audits Are No Longer Sustainable Against Rising Payer Scrutiny.” The piece examines how the auditing environment has fundamentally shifted and why healthcare organizations must adopt proactive compliance strategies.
Ritesh discusses how coding related denials increased 120 percent in 2023 and inpatient medical necessity denials grew by 140 percent, while commercial payer requests for information rose 122 percent. He explains that traditional retrospective audits come too late to prevent financial loss, and healthcare organizations are now recognizing the need to adopt proactive, risk based compliance programs that integrate data, automation, and real time oversight. The article emphasizes that by identifying issues before claims are submitted and targeting high risk areas based on payer behavior, organizations can prevent denials before they occur and recover significant revenue. Read the full article on HIT Consultant and learn more about MDaudit’s proactive audit solutions.
