Healthcare providers face growing audit pressures—from Recovery Audit Contractors (RACs) and Zone Program Integrity Contractors (ZPICs) to commercial insurers—and need a solution that ties revenue protection to compliance. MDaudit’s unified Revenue Integrity and Compliance Platform brings together automated audits, denial analytics, coding-workflow integration, and continuous risk monitoring in one cloud-native suite.
Audit Automation with MDaudit
Manual audits slow you down. MDaudit automatically generates audit tasks whenever its predictive models flag high-risk claims. Those tasks flow straight into MDaudit’s Audit Workflows module, where reviewers see assignments in their dashboards, track progress in real time, and store all documentation in a secure, version-controlled repository.
Denial Analytics Powered by MDaudit
Counting denials isn’t enough. MDaudit uses AI trained on historical denial data to pinpoint root causes and forecast which claims are most at risk. Its Revenue Integrity Platform correlates audit findings with remittance records, putting a dollar value on each exception as it occurs and guiding targeted corrective actions.
Integrating MDaudit into Coding Workflows
Since coding errors drive many denials, MDaudit embeds alerts directly into coders’ environments—whether within an Electronic Health Record or a standalone workstation. When modifier use deviates from policy or code levels that lack documentation, MDaudit surfaces contextual guidance right where coders work, preventing errors before submission.
Continuous Risk Monitoring by MDaudit
MDaudit’s Continuous Risk Monitoring ingests daily claims, remittance advice, and clinical documentation, applying predictive analytics to catch anomalies the moment they appear. These real-time alerts shift compliance from reactive quarterly reviews to an always-on preventive guardrail.
Scalability and Security with MDaudit
From single-site practices to multi-state health systems, MDaudit’s cloud-native architecture scales automatically under heavy data loads. It also maintains HIPAA-compliant encryption, role-based access, and detailed audit logs—and holds HITRUST certification to prove its security posture.
Partnering with MDaudit for Success
Technology alone won’t drive adoption—MDaudit pairs its platform with robust onboarding, role-based training, and responsive support. We recommend forming a governance council of compliance, HIM, coding, and revenue cycle leaders to guide configuration and champion best practices.
Cost, ROI, and Future-Proofing
MDaudit clients typically achieve payback within 12–18 months through reduced denials, prevented overpayments, and labor savings. And because MDaudit invests continuously in AI, NLP, and emerging technologies—like predictive forecasting and blockchain audit trails—your investment stays ahead of regulatory change.
