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Stay Informed With Risk Analytics
The MDaudit Billing Risks option leverages the charge data ingested regularly from your organization’s claims to bring new insights to healthcare billing compliance and revenue integrity teams. The drill-down dashboards and reports allow you to detect billing and coding anomalies and determine root cause, or risk, with pre-built analytics and peer benchmarking tools. Easily identify opportunities to improve revenue and establish risk-based auditing practices.
Direct Benefits Using Billing Risks
Auto-identify and rank your “at-risk” provider population (overcoding, undercoding, new providers)
Get system-driven alerts into billing practices falling outside of normative ranges (versus PEPPER, OIG, CMS, RACs, MDaudit Community, etc.)
Exploit sophisticated, data-driven analytics and AI that will identify billing compliance risks and how to reduce revenue leakage
Gain actionable insights that will help you make strategic financial and operational decisions to support a healthier bottom line
Discover 360 views/dashboarding so risks are front and center for immediate analysis and resolution/corrective action
Auto-Ingestion of Claims Data
Daily ingestion of your claims data (837I, 837P) allows for real-time identification of harmful billing trends. Drill-down dashboards and reports allow you to detect billing and coding anomalies and determine root causes or risk with pre-built analytics.
Benchmarking Capability
Benchmark versus CMS, the MDaudit community, and internally at your organization to provide direction and magnitude into billing risks. Easily identify opportunities to improve revenue and establish risk-based auditing practices.
Seamless Workflows
Seamless integration from analytics to workflows allows for analysis, rectification, and corrective action in one closed-loop process.
