Healthcare Revenue Integrity Management

Get proactive to minimize revenue risk

• Perform self-audits on claims independent of an official payer audit
• Identify at-risk claims and payments before a payer finds them
• Receive alerts when a claim is already under review

Automate to improve efficiency, reduce errors

• Automated workflows route claims through the entire audit and appeal process
• Stay on top of the audit and appeals process with with email notifications and reminders
• Identify at-risk billing and payments via one-time or scheduled searches on claim and remit data.

Easily report on and analyze claims data

• Real-time graphical dashboards provide a high-level view, while robust visualization tools let you dig into the data
• Customize dashboards based on individual roles and responsibilities
• Embedded advanced report writer can be used to design reports for different stakeholders

Integrate with the systems you depend on

• esMD (Electronic Shipment of Medical Documentation) integration eliminates the need for manual shipping and faxing of: medical records, RAC discussions, Medicare pre-authorizations, and appeals.
• Take advantage of our platinum-level integration with Optum’s Executive Health Resources (EHR) to manage your appeals process.

Explore our
pre-built healthcare modules

The SAI360 Healthcare GRC solution offers tailor-made modules for healthcare and managed care providers in the US.