Institutional Audit Manager

Assess and reduce reimbursement risk before your payers do with Institutional Audit Manager.

Institutional Audit Manager allows users to conduct and manage all their internal institutional audits, and helps organizations obtain appropriate reimbursement, promote operational improvement, and reduce compliance risk.

Designed for hospitals and other institutions, this powerful solution allows you to perform internal audits rapidly and accurately. As the backbone of hospital compliance and auditing programs, Institutional Audit Manager makes it possible to institutionalize best auditing practices, reduce risk, protect revenue and promote continuous operational improvement.

NEW! Institutional Audit Manager allows you to proactively target risk areas of non-compliance with Risk Identification and Analytics:

Develop targeted audit plans with access to 90+ pre-defined global risk areas
Gain visibility into external risk areas (OIG, PEPPER, RAC) and define custom risk areas specific to your unique organization
Support data driven decision making using analytics that show financial impact, prior audit penetration and performance rates
Track results and drill down with these top risk area dashboards:

Volume
Charges and payments
Type of risk
Audit rates and accuracy
Over/under billing financial impact

Manage all audits in a single system

Keep all your audits in one place where you can easily monitor them and later report on audit trends. Avoid juggling multiple spreadsheets or systems. Allow different departments, such as compliance, revenue integrity, and HIM, to conduct their own audits. Institutional Audit Manager can import data from multiple sources, displaying all the information you need in one standardized view.

Target organizational risks

Institutional Audit Manager lets you rapidly identify at-risk accounts to conduct risk-based audits like payers and third-party auditors do. The system provides benchmarks – like PEPPER target areas – to show you when you fall above or below normative standards. By identifying high-risk areas and outliers, you can immediately investigate risks and determine how to address them.

Improve audit efficiency and effectiveness

Institutional Audit Manager automates many tasks, from scheduling and populating audits with randomly selected cases through QA and follow up actions. The solution allows you to streamline your audit process while building in best practices. The result is higher productivity, fewer errors, and improved auditing practices, all while saving time and costs. You can also conduct pre-bill audits to correct bills before submission, shortening collection time.

Gain insights on risks and operational improvement

Leverage analytics and detailed feedback to reduce risks, identify missed revenue opportunities, and evaluate financial impacts. Executive dashboards and reports provide accuracy rates, root causes, patterns of denial, auditor productivity, and other actionable information. Audit and auditor performance can be monitored in real time to assess productivity and audit results. Detailed feedback can be delivered to coders, chairpersons, and others about performance.