Welcome to ClaimsAuditor.com!
ClaimsAuditor.com is the Nation’s newest, fastest and most flexible tool to assist Clinical, Coding and Financial professionals uncover coding, compliance and reimbursement risks and opportunities hidden in their provider claims and other detail data. ClaimsAuditor.com IS NOT an EDI system or “scrubber”. Rather it is a more sophisticated tool allowing users to apply and create rules not typically found in such systems. The system facilitates a more cost efficient and effective focused review and audit approach.
With ClaimsAuditor.com you will be able to query and select records for review. You’ll be able to select from hundreds of rules from our library or even design your own. You’ll be able to select those charts or claims having the highest probability for a coding, compliance, quality or billing discrepancy and do so retrospectively or concurrent with the billing process.
With ClaimsAuditor.com you be able to instantly query records that are likely ...
- Underpayments due to coding and/or documentation
- Overpayments due to coding and/or documentation
- RAC audit targets
- Quality issues
- Medical Necessity targets
- CERT, MIC, MAC, PSC, and OIG targets
- CC/MCC Capture Rates
- Unbilled services ( Lost Charges )
- Underbilled services
- and much more