Revenue Integrity Suite

JSON twin: https://www.healthaidb.com/software/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

• revenue Cycle
• health Data Analytics
• compliance Management
• financial Management
• Revenue Cycle Management
• Denial Management
• Healthcare Analytics
• Compliance Monitoring

Summary

MDaudit's Revenue Integrity Suite is a cloud-based platform that proactively manages high-impact denials to optimize healthcare revenue cycles.

Description

MDaudit's Revenue Integrity Suite integrates risk capabilities and workflows into a single platform, automating end-to-end denial prevention by analyzing payer remittance data, applying insights to pre-payment charges, and recommending audits to correct claims before submission, thereby preventing denials and improving cash flow.

Api Available

unknown

Certifications

• HITRUST CSF Certified
• TX-RAMP Level 2
• CSA STAR Level 1 (C-STAR)
• CORL Cleared

Company Founding

2012

Company Offices

• United States

Compliance

• HIPAA
• HITRUST CSF
• TX-RAMP (Level 2)
• CSA STAR (Level 1)
• CORL

Customers

• "MDaudit Enterprise" users include healthcare organizations such as hospitals and health systems.

Data Residency

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

Data Standards

• X12 835 (ERA)
• CPT
• ICD-10
• HCPCS
• DRG
• HCC

Deployment Model

• SaaS

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
• Internal audit workflows (hospital, professional, coder)
• Automated data pulls and sample selection
• Billing risk analytics / continuous risk monitoring
• Revenue Optimizer (revenue cycle workflows)
• Denials Predictor (denial trend detection)
• Payer audit management
• Coder workflow with review/rebuttal
• AI Assist (natural language / analytics-driven insights)

Id

SW1739

Integration Partners

• Tebra
• ModMed
• WebPT
• NextGen Healthcare EHR
• Compliance Manager GRC
• Waystar
• Rectangle Health
• athenaOne

Integrations

• Epic
• Cerner
• Meditech
• eClinicalWorks
• Amazon Web Services (AWS)
• ThoughtSpot
• Streamline Health
• Payer remits / clearinghouse remittance feeds (X12 835)
• Billing / claims systems
• EHR systems (general EHR integration; vendor names not specified)
• Payer portals / payer data sources

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• SmartScan.ai
• Insights.ai

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• Business Associate Agreement (BAA) with cloud provider (AWS)
• PHI protection measures
• Secure backups
• Data encryption

Product Code

SW1739

Product Name

Revenue Integrity Suite

Ratings

• "MDaudit Enterprise" has a 5.0 overall rating on Capterra, based on 8 reviews. ([capterra.com](https://www.capterra.com/p/264988/MDaudit-Enterprise/?utm_source=openai))

Regions Available

• United States

Related Urls

• https://elion.health/products/mdaudit-revenue-integrity-suite

Release Year

2015

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

Specialties

• Hospital Revenue Cycle
• Outpatient Services
• Ambulatory Surgical Centers
• Durable Medical Equipment
• Specialty Drugs
• Medical Necessity Compliance
• Coding Accuracy
• Clinical Documentation Improvement

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• revenue cycle managers
• billing compliance auditors
• healthcare administrators
• finance teams

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• MDaudit has been evolving and is a better product today than it was last year.
• Our experience with MD Audit has been wonderful since day 1.
• MD Audit customer service is off the charts.
• MDaudit Enterprise has been helpful in determining the most high risk areas to focus our auditing efforts.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Revenue Integrity Suite",
  "company_name": "MDaudit",
  "product_url": "https://www.mdaudit.com/solutions/revenue-integrity/revenue-integrity-suite/",
  "company_url": "https://www.mdaudit.com/",
  "related_urls": [
    "https://elion.health/products/mdaudit-revenue-integrity-suite"
  ],
  "product_code": "SW1739",
  "summary": "MDaudit's Revenue Integrity Suite is a cloud-based platform that proactively manages high-impact denials to optimize healthcare revenue cycles.",
  "description": "MDaudit's Revenue Integrity Suite integrates risk capabilities and workflows into a single platform, automating end-to-end denial prevention by analyzing payer remittance data, applying insights to pre-payment charges, and recommending audits to correct claims before submission, thereby preventing denials and improving cash flow.",
  "categories": [
    "revenue Cycle",
    "health Data Analytics",
    "compliance Management",
    "financial Management",
    "Revenue Cycle Management",
    "Denial Management",
    "Healthcare Analytics",
    "Compliance Monitoring",
    "Financial Management"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "revenue cycle managers",
    "billing compliance auditors",
    "healthcare administrators",
    "finance teams"
  ],
  "specialties": [
    "Hospital Revenue Cycle",
    "Outpatient Services",
    "Ambulatory Surgical Centers",
    "Durable Medical Equipment",
    "Specialty Drugs",
    "Medical Necessity Compliance",
    "Coding Accuracy",
    "Clinical Documentation Improvement"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2012",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "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",
    "Internal audit workflows (hospital, professional, coder)",
    "Automated data pulls and sample selection",
    "Billing risk analytics / continuous risk monitoring",
    "Revenue Optimizer (revenue cycle workflows)",
    "Denials Predictor (denial trend detection)",
    "Payer audit management",
    "Coder workflow with review/rebuttal",
    "AI Assist (natural language / analytics-driven insights)"
  ],
  "optional_modules": [
    "SmartScan.ai",
    "Insights.ai"
  ],
  "integrations": [
    "Epic",
    "Cerner",
    "Meditech",
    "eClinicalWorks",
    "Amazon Web Services (AWS)",
    "ThoughtSpot",
    "Streamline Health",
    "Payer remits / clearinghouse remittance feeds (X12 835)",
    "Billing / claims systems",
    "EHR systems (general EHR integration; vendor names not specified)",
    "Payer portals / payer data sources"
  ],
  "data_standards": [
    "X12 835 (ERA)",
    "CPT",
    "ICD-10",
    "HCPCS",
    "DRG",
    "HCC"
  ],
  "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)",
    "PHI protection measures",
    "Secure backups",
    "Data encryption"
  ],
  "data_residency": "Hosted on AWS (US regions; specific region options available on request)",
  "customers": [
    "\"MDaudit Enterprise\" users include healthcare organizations such as hospitals and health systems."
  ],
  "user_reviews": [
    "MDaudit has been evolving and is a better product today than it was last year.",
    "Our experience with MD Audit has been wonderful since day 1.",
    "MD Audit customer service is off the charts.",
    "MDaudit Enterprise has been helpful in determining the most high risk areas to focus our auditing efforts."
  ],
  "ratings": [
    "\"MDaudit Enterprise\" has a 5.0 overall rating on Capterra, based on 8 reviews. ([capterra.com](https://www.capterra.com/p/264988/MDaudit-Enterprise/?utm_source=openai))"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2015",
  "integration_partners": [
    "Tebra",
    "ModMed",
    "WebPT",
    "NextGen Healthcare EHR",
    "Compliance Manager GRC",
    "Waystar",
    "Rectangle Health",
    "athenaOne"
  ],
  "id": "SW1739",
  "slug": "revenue-integrity-suite",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/revenue-integrity-suite.json"
  }
}