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Third-Party Audit Management
Managing third-party governmental and private payer audits, such as Recovery Audit Contractors (RAC), Targeted Probe and Educate (TPE), and Comprehensive Error Rate Testing (CERT) audits, can be challenging without the right tools. The manual effort of tracking requests, pulling records, reporting results, and staying on top of due dates is time consuming and inefficient. MDaudit makes it easy to manage external audit requests in a single centralized, secure platform.
Direct Benefits Using Payer Audit Management
Optimize response times to external auditing requests for government and commercial payers
Automate unwieldy, manual tasks to ensure deliverables are executed on time and in sync with challenging appeals deadlines
Recognize successful appeals and significantly reduce refunds through automation and a streamlined workflow, ensuring revenue protection
Gain full transparency via dashboarding and AI into what is being targeted, why, and by who
Payer Audit Benchmarking
A variety of benchmarking dashboards to assist revenue integrity professionals in understanding who’s targeting them, what’s being targeted, and why, along with associated financial outcomes. Analytics and benchmarking data are provided from the MDaudit community.
Electronic Submission
With esMD, electronic submission of medical documentation ensures the timely filing of all ADRs and supporting appeals documentation. Skip the payer and government audit portals with this single point of submission and tracking for audit responses. Optimize response times to external requesters, and save significant costs on printing, faxing, labor, and mailing.
Document Management & Storage
MDaudit acts as a centralized, HIPAA-compliant repository of all documentation needed, including demand letters, determination letters, medical records, appeals documentation, and more. Attach supporting documentation to audits and easily share internally or externally.
Automated Task Management
Gain the ability to pre-configure and create impromptu tasks to be sent to parties responsible for executing them, ensuring timely responses to external requestors. Track due dates, and report on task assignments and progress.
Sophisticated Reporting & Dashboarding
Detailing tasks in-flight and past-due, accurate reporting and dashboards ensure the effective deployment of resources and provide organizational awareness. Flexible reporting provides both executive-level insight and the ability to deep dive into data.
Seamless Workflows
Synergies exist between the MDaudit internal audit workflows and the Payer Audit Workflow, allowing critical communication to take place ensuring maximum revenues are retained.
SmartScan.ai
Within the Payer Audit Workflow module, this intelligent functionality allows users to upload payer request letters which are parsed to extract relevant attributes for case searches, enabling a much simpler search. This eliminates tedious manual work, adding an iterative case search process with more flexibility and expediting the overall resolution of audits.
esMD (Electronic Submission of Medical Documentation)
As a component of MDaudit’s Payer Audit Workflow, esMD allows users to have a single point of submission and tracking audit documentation, expediting response times back to review contractors. Users benefit from significant cost savings on printing, faxing, labor, and mailing while reducing errors and ensuring your documentation has reached its intended destination.
