MDaudit Enterprise Audit Workflows
Accelerate the productivity of your auditing processes through automation.
MDaudit Enterprise’s medical billing audit software enables your organization to be more efficient with the tools necessary to automate time consuming tasks to enable a more strategic approach to auditing.
Compared to traditional methods, auditors using the MDaudit audit tools significantly increase their efficiency and productivity by eliminating non-value-added time spent on labor-intensive preparation and reporting tasks. By combining automated workflows with continuous risk monitoring and anomaly detection, organizations can quickly identify risks, determine the root cause of errors, and apply corrective actions to prevent future losses.
Effortless Security and Peace of Mind
The MDaudit Enterprise Audit Workflows provide a single-source solution for examining all chart types within your organization, including hospital charges, professional charges, and coder performance, both prospectively and retrospectively. Internal and external audits can be more efficiently managed through templated and customizable audit workflows, automated task management, and digital document management. Additionally, MDaudit Enterprise provides robust audit reporting capabilities with advanced analytics dashboards that enable users to uncover insights quickly.
Key Benefits
Focus on process improvement, not just error detection, with true insights into the cause of coding errors and the tools to educate and correct them.
Collaborative platform to bring all your stakeholders together on focused, targeted insights available through robust reporting and intuitive dashboards.
A closed-loop solution that automatically ingests your data, creates audits, identifies trends, displays results, and offers advanced analytics of billing and remittance data.
Dramatically Improve Auditing Efficiency
Key Features:
• Enterprise healthcare auditing software ingests claims data to automatically create audits
• Helpful worksheets and curated content
• Financial impact analysis shows the impact of auditing efforts
• Auditor productivity and outcome reports to measure performance
• Robust reporting and analytics include prebuilt and ad-hoc capabilities
• QA and coder review tools available to fit with your organizational needs
• Task tracking and reporting to manage deadlines and coordinate activities
• HIPAA-compliant document repository to attach documents to audits
Available Workflows
Professional Billing (PB) Audit Workflow
MDaudit professional billing workflow helps healthcare organizations assess their risk of an audit by comparing professional coding practices against those of their peers. The platform offers benchmarking data from both CMS and MDaudit community. By objectively assessing the risk, auditors and practice staff can work together to educate teams and develop mitigation plans to prevent adverse audit findings.
Specialized Professional Billing Audit Features:
- Audit professional charges including research trials
- Powerful scheduled audit planner
- Auditing aides such as E&M and risk area worksheets
- QA reviewer functionality
- Corrective action tools and audit result reporting
- Insights into the financial impact of audit findings
Hospital Billing (HB) Audit Workflow
Healthcare organizations can easily audit facility charges to ensure claims have been coded and submitted with the highest degree of accuracy. Revenue integrity professionals can perform extensive reviews of itemized bills, as well as a variety of settings including but not limited to inpatient acute care, outpatient facility, skilled nursing, long term acute care, and rehabilitation facilities.
Specialized Hospital Billing Audit Features:
- Automated random sampling for CCs, MCCs, HCCs, etc.
- Scheduling capabilities for the re-auditing of high-risk DRGs
- Risk area worksheets and curated content
- Financial impact analysis showing the impact of audits
- QA reviewer functionality
- Optional analytics module enables identification of anomalous billing patterns of PEPPER metrics
External Auditing Workflow
The first line of defense against external audits is a centralized and streamlined process for receiving requests, assessing claims, and qualifying appeals and payments. With MDaudit external audit workflow, you can improve cross-departmental collaboration and productivity to meet even the toughest audit workloads and schedules.
Specialized External Audit Features:
- Automated processes to assess and respond to external audits
- Simplify coordination between internal stakeholders with task tracking
- Comprehensive tracking and data visualizations that provide full transparency into the statuses of external audits
Coder Audit Workflow
Coder audit workflow helps you identify and educate coders (new and experienced) proactively so you can invest more time in education and corrective action to ensure charges are being billed compliantly and accurately, increase first pass pay rates, decrease days in accounts receivable, and accelerate cashflow through maximized reimbursement.
Specialized Coder Audit Features:
- Risk areas identification (e.g. automatic identification of new coders to your organization)
- Coder audit management
- Coder rebuttal in a collaborative platform that engenders healthy dialogue between auditors and coders until resolution has been achieved
The MDaudit Enterprise Platform
Auditing Workflow
Accelerate productivity with automated workflows.
Billing Risk
Detect anomalies and determine root cause. Compare your risk levels to peer organizations.
Revenue Optimizer
Actionable insights to maximize revenue.
MDaudit Enterprise is HITRUST Certified
HITRUST CSF Certified status demonstrates that MDaudit Enterprise system hosted by AWS has met key regulations and industry-defined requirements and is appropriately managing risk.
MDaudit Enterprise is TX-RAMP Certified
MDaudit has achieved Level 2 certification for the Texas Risk and Authorization Management Program, or TX-RAMP. This program of the Texas Department of Information Resources provides a standardized approach to security assessment, authorization, and continuous monitoring of cloud computing services used by Texas state agencies, including university healthcare systems. Authorization and certification under TX-RAMP require cloud computing services to conform to a subset of the NIST 800-53 cybersecurity controls.
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