Solutions > Compliance & Policy Management > Healthcare Revenue Integrity Management

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.

Explore our
pre-built healthcare modules

The SAI360 Healthcare GRC solution offers tailor-made modules for healthcare and managed care providers in the US.

Reduce revenue leaks and be audit-ready.

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Kind regards,

The SAI360 team