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Healthcare Revenue Integrity Management

Be proactive. Gain complete control of the entire audit process while managing denials and audits.

Revenue Risk Dashboard Claims Remittances

Get proactive to minimize revenue risk

  • Perform self-audits on claims independent of an official payer audit
  • Identify at-risk claims and payments before a payer finds them
  • Receive alerts when a claim is already under review

Automate to improve efficiency, reduce errors

  • Automated workflows route claims through the entire audit and appeal process
  • Stay on top of the audit and appeals process with with email notifications and reminders
  • Identify at-risk billing and payments via one-time or scheduled searches on claim and remit data.
View claims data proactively to improve reimbrsements.
Real-time Claims and Denials Dashboard

Easily report on and analyze claims data

  • Real-time graphical dashboards provide a high-level view, while robust visualization tools let you dig into the data
  • Customize dashboards based on individual roles and responsibilities
  • Embedded advanced report writer can be used to design reports for different stakeholders

Integrate with the systems you depend on

  • esMD (Electronic Shipment of Medical Documentation) integration eliminates the need for manual shipping and faxing of: medical records, RAC discussions, Medicare pre-authorizations, and appeals.
  • Take advantage of our platinum-level integration with Optum’s Executive Health Resources (EHR) to manage your appeals process.

Featured News & Insights

Reduce revenue leaks and be audit-ready.

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