InvisaClaim

MDaudit is a cloud-based platform that unifies billing compliance, coding audits, and revenue-integrity workflows for healthcare providers, hospitals, physician networks, ambulatory surgical centers, and the like. It supports all types of audits, scheduled, risk-based, retrospective, and denial-focused. MDaudit automates data ingestion from pre-bill charges, claims, and remittance data; triggers audit workflows; flags anomalies and high-risk patterns; and delivers real-time dashboards and drill-down analytics revealing root causes of billing errors, denials, and revenue leakage. Its modules, including a “Denials Predictor” for pre-submission claim validation and a “Revenue Optimizer” for continuous risk monitoring, help organizations prevent claim denials, reduce recoupments, and capture more legitimate revenue. MDaudit also provides payer-audit management: a secure, centralized workflow to respond to external audit requests and manage documentation exchange.

Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS.