mdaudit-revenue-integrity-suite

JSON twin: https://www.healthaidb.com/software/mdaudit-revenue-integrity-suite.json

Company Name

MDaudit

Product URL

https://www.mdaudit.com/solutions/revenue-integrity/revenue-integrity-suite/

Company URL

https://www.mdaudit.com

Categories

Summary

Cloud-based revenue integrity platform that analyzes payer remits and pre-bill charges to predict, prioritize, and prevent high-impact claim denials.

Description

MDaudit Revenue Integrity Suite combines payer-remit (835) analytics, a nationwide payer-centric rules engine, predictive pre-bill screening, retrospective and prospective auditing workflows, and visual denial analytics to identify root causes of high-dollar denials, recommend corrective actions, and create a closed-loop feedback process to improve cash flow and reduce denials.

Api Available

unknown

Certifications

Company Founding

1993

Company Offices

Compliance

Customers

Data Residency

Hosted on AWS (US regions; specific region options available on request)

Data Standards

Deployment Model

Features

Id

P0992

Integration Partners

Integrations

Languages Supported

Last Updated

2025-09-07

License

commercial_proprietary

Links

Market Segment

Optional Modules

Os Platforms

Pricing Details

Contact vendor for pricing, demo and discovery — no public pricing listed.

Pricing Model

enterprise_quote

Privacy Features

Ratings

Regions Available

Release Year

1993

Security Features

Specialties

Support Channels

System Requirements

Target Users

Training Options

Type

product

User Reviews

Version

1.0

Canonical JSON

{
  "company_name": "MDaudit",
  "company_url": "https://www.mdaudit.com",
  "company_offices": [
    "United States"
  ],
  "company_founding": "1993",
  "product_url": "https://www.mdaudit.com/solutions/revenue-integrity/revenue-integrity-suite/",
  "categories": [
    "administrative",
    "revenue integrity",
    "revenue intelligence",
    "billing compliance",
    "HIM / coding",
    "denials management",
    "audit workflows"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "links": [
    "https://www.mdaudit.com/solutions/revenue-integrity/revenue-integrity-suite/",
    "https://www.mdaudit.com/",
    "https://www.mdaudit.com/about/",
    "https://www.mdaudit.com/solutions/revenue-integrity/revenue-optimizer/",
    "https://www.mdaudit.com/solutions/revenue-integrity/denials-predictor/",
    "https://www.mdaudit.com/why-choose-us/data-security/",
    "https://elion.health/products/mdaudit-revenue-integrity-suite",
    "https://www.mdaudit.com/wp-content/uploads/2023/07/KLAS-MDaudit-First-Look.pdf",
    "https://www.mdaudit.com/resource/press-release/mdaudit-finalizes-acquisition-of-streamline-health"
  ],
  "summary": "Cloud-based revenue integrity platform that analyzes payer remits and pre-bill charges to predict, prioritize, and prevent high-impact claim denials.",
  "description": "MDaudit Revenue Integrity Suite combines payer-remit (835) analytics, a nationwide payer-centric rules engine, predictive pre-bill screening, retrospective and prospective auditing workflows, and visual denial analytics to identify root causes of high-dollar denials, recommend corrective actions, and create a closed-loop feedback process to improve cash flow and reduce denials.",
  "target_users": [
    "revenue cycle managers",
    "billing staff",
    "coding/HIM teams",
    "compliance officers",
    "denials management teams",
    "finance/treasury",
    "clinical documentation specialists",
    "internal auditors",
    "IT/integration teams"
  ],
  "specialties": [
    "Cardiology",
    "Pharmacy / specialty drugs",
    "Durable Medical Equipment (DME) / implants",
    "Outpatient services",
    "Ambulatory Surgical Centers (ASC)"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "enterprise_quote",
  "pricing_details": "Contact vendor for pricing, demo and discovery — no public pricing listed.",
  "license": "commercial_proprietary",
  "features": [
    "835 remittance analysis for denial trend diagnosis",
    "Payer‑centric rules engine to predict denials",
    "Pre-payment (pre-bill) charge screening and flagging",
    "Retrospective audit scheduling and workflows",
    "Predictive analytics for high-value denials",
    "Visual dashboards and denial analytics (360° view)",
    "Prospective audit/distribution to internal stakeholders",
    "Automated sample selection of at‑risk charges",
    "Claim correction recommendations prior to submission",
    "Provider and coder education/workflow feedback loop",
    "Root‑cause identification and prioritization of denial risks",
    "Projected savings and ROI reporting"
  ],
  "integrations": [
    "Payer remits / clearinghouse remittance feeds (X12 835)",
    "Billing / claims systems",
    "EHR systems (general EHR integration; vendor names not specified)",
    "Payer portals / payer data sources"
  ],
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "optional_modules": [
    "Denials Predictor",
    "Revenue Optimizer",
    "Payer Audit Management"
  ],
  "data_standards": [
    "X12 835 (ERA)"
  ],
  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITRUST CSF",
    "TX‑RAMP (Level 2)",
    "CSA STAR (Level 1)",
    "CORL"
  ],
  "certifications": [
    "HITRUST CSF Certified",
    "TX‑RAMP Level 2",
    "CSA STAR Level 1 (C‑Star)",
    "CORL Cleared"
  ],
  "security_features": [
    "Data encryption at rest and in transit",
    "Multi‑factor authentication",
    "Single sign‑on (SSO)",
    "Role‑based access controls",
    "Audit logging",
    "Regular penetration testing and continuous risk assessments"
  ],
  "privacy_features": [
    "Business Associate Agreement (BAA) with cloud provider (AWS)",
    "HIPAA Privacy Rule compliance"
  ],
  "data_residency": "Hosted on AWS (US regions; specific region options available on request)",
  "customers": [
    "Rogers Behavioral Health",
    "Baylor College of Medicine",
    "Eskenazi Medical Group",
    "San Juan Regional Medical Center",
    "CommonSpirit Health",
    "Large multispecialty practices (case studies)",
    "Faith-based nonprofit (case study)"
  ],
  "user_reviews": [
    "The software is intuitive with many resources for auditors to audit and multiple data to report on for management.",
    "Very user friendly — a terrific all-in-one tool that houses claims and denials data for the organization.",
    "I like the UI — simple, intuitive and easy to use.",
    "Customer service aspect is on point; implementation and training were thorough.",
    "Advanced analytics helped us identify significant revenue risk and recover lost revenue."
  ],
  "ratings": [
    "Glassdoor: 3.5/5 (employee reviews)"
  ],
  "support_channels": [
    "email",
    "phone",
    "ticketing",
    "customer success manager",
    "community/peer community"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online (instructor-led)",
    "eLearning",
    "periodic live workshops / consultative coaching"
  ],
  "release_year": "1993",
  "integration_partners": [
    "Epic",
    "Cerner",
    "Meditech",
    "eClinicalWorks",
    "Amazon Web Services (AWS)",
    "ThoughtSpot",
    "Streamline Health"
  ],
  "id": "P0992",
  "slug": "mdaudit-revenue-integrity-suite",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-09-07",
  "links_json": {
    "self": "https://www.healthaidb.com/software/mdaudit-revenue-integrity-suite.json"
  }
}