MDaudit Enterprise

MDaudit’s internal audit workflows automate the full audit lifecycle, from planning and sampling to reporting and follow-up. Standardized forms, random or risk-based selections, and real-time dashboards help teams maintain consistency, speed up review times, and track progress clearly. It scales audit work without needing more staff.

This feature helps manage external payer audits efficiently by centralizing all cases in one platform. It tracks documentation, payer correspondence, deadlines, and responses. Standardized workflows and reporting ensure nothing falls through the cracks and help teams coordinate internally to resolve audit findings faster.

Billing Risks identifies errors, anomalies, and trends in procedural billing that could affect revenue. It uses analytics to highlight outliers and monitor claims across different services, payers, and facilities. This gives teams insight into high-risk areas so they can fix issues before audits or denials occur.

The Revenue Integrity Suite brings together retrospective denial data with predictive rules to identify and prevent issues before claims are submitted. It uses AI-powered detection and analytics to find documentation or coding issues and integrates those insights into audits and corrective workflows.

Revenue Optimizer uses AI-powered analytics to explore denial trends, root causes, and high-dollar revenue drivers. With more than 40 dashboard views, CPT, DRG, payer, facility, and more, it identifies where to act. Seamless integration with audit workflows allows users to launch reviews based on anomalies found.

Denials Predictor adds a pre‑payment validation layer to catch potential denials before claims are sent. It applies payer-centered rules to high-value charges, like specialty drugs or implants, and flags risky claims, helping reduce appeals, write-offs, and delays proactively.

MDaudit’s Coder Workflow enhances coding quality checks by integrating coder review tools directly into the audit platform. It includes automated audit worksheets, collaborative dashboards, task tracking, and a HIPAA-compliant document repository. Coders can receive real-time feedback, review peer audits, and follow corrective actions.