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Internal Audit Workflows

Accelerate the productivity of your internal auditing processes through automation.

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Comprehensive Workflow Platform

The MDaudit Audit Workflows provide a single-source solution for examining all chart types within your organization, including hospital, professional, and coders, both prospectively and retrospectively. Audits can be more efficiently managed through templated and customizable workflows, automated schedules, task assignments, and digital document management. Additionally, MDaudit provides robust audit reporting capabilities with advanced analytics dashboards that enable users to uncover insights quickly.

Direct Benefits Using Internal Audit Workflows

Automate data pulls (and sample sizes) for professional, hospital, coder, and dental coding quality audits

Eliminate spreadsheets and time-consuming manual processes

Increase time spent on coding quality audits, leaving ample time for education/corrective action with providers, coders, etc.

Experience productivity, efficiency, and confidence when performing your billing compliance audits

No more dependency on IT and others to provide you with the data you need

Intuitive Automation and Workflows

Easily request the data you need (by CPT, DRG, provider, coder, HCC, DX codes, etc.), while automation enables you to be more efficient with the tools necessary to simplify time-consuming tasks enabling a more strategic approach to auditing. Combine automated workflows with continuous risk monitoring and anomaly detection to quickly identify risks, determine the root cause of errors, and apply corrective actions to prevent future losses.

Robust E&M Worksheets

Make more accurate leveling decisions. Simply enter information for history, exam, medical decision-making, and time based on the medical record, and MDaudit will help you calculate a supported level based on the CMS guidelines for E&M services.

Intuitive Auditing Aids

Create custom auditing aids based on what the OIG is scrutinizing as well as NCDs, LCDs, MLN Matters and more, when making difficult decisions in challenging billing scenarios. Worksheets can be associated with any field that can be audited in the case detail. Additionally, Risk Area Worksheets can cover any topic that will improve audit result consistency. Create new ones from curated templates or build customized templates based on the unique needs of an organization.

Accurate Measurement and Reporting

MDaudit offers a multitude of reporting packages that auto-capture everything done during the audit process so you can spend more time meeting with providers and coders for education and have them take action on the findings. Use Audit Insights to show senior management the effectiveness of compliance programs by incorporating all audit data into visuals and tables where you can filter and drill into specific data points to further refine your needs.

Insights.ai (Conversational AI)

This robust feature allows you to ask simple yet very detailed questions about your audits in plain English and will immediately generate the results you need.

Scheduled Audit Planner

Designed to streamline and automate your audit scheduling processes by providing a robust set of tools for audit scheduling and creation, the Scheduled Audit Planner allows you to define how different provider and coder audits will be scheduled based on previous audit results, and much more.

Available Audit Workflows

Hospital Workflow

Easily audit high-risk DRGs, HCCs, CC/MCCs, and all other focuses of CMS and OIG, and leverage facility risk metrics to identify auditing targets. Audit inpatient and outpatient services rendered, for example, ASC surgical services or an inpatient DRG encounter; conduct audits prospectively and retrospectively, and use sophisticated dashboards and data visualizations that pinpoint risk and future auditing focus areas.

Professional Workflow

Seamlessly audit providers’ billing activity, and easily audit fee-for-service and value-based care models. Audit HCCs and see weight changes, and conduct audits prospectively and retrospectively. Dive into sophisticated dashboards and data visualizations pinpointing risk and future auditing focus areas.

Coder Workflow

Audit coders’ overall integrity and accuracy for both professional and hospital billing and facilitate healthy dialogue between auditors and coders through a robust review and rebuttal workflow. Leverage prospective and retrospective audits and utilize sophisticated dashboards and data visualizations that pinpoint risk and future auditing focuses.

Jackie Gallagher
National Spine and Pain Centers
Data Analyst

Every little dollar adds up to a lot of dollars. It’s important that we get paid what we should so we can continue helping patients and ensuring our professionals can get paid for those services. MDaudit helps us do that.

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