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MDaudit Denials Predictor

The single platform for billing compliance, coding, and revenue integrity.

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Overview

MDaudit is a comprehensive, cloud-based platform for healthcare revenue integrity and compliance. Its Denials Predictor module is designed to proactively identify and resolve claims that are likely to be denied for clinical or medical necessity reasons, which are often missed by traditional claim scrubbers. By applying a payer-centric rules engine to pre-bill charges, the platform helps organizations improve their first-pass payment rate and reduce costly rework and appeals.

✨ Key Features

  • Pre-bill denial prediction
  • Payer-centric rules engine
  • Identifies clinical and medical necessity risks
  • Automated audit workflows
  • Root cause analysis dashboards
  • Billing compliance and risk monitoring

🎯 Use Cases (3)

Hospital revenue integrity teams. Compliance officers seeking to reduce billing risks. Large medical groups aiming to improve clean claim rates.

✅ Best For

  • Identifying high-dollar claims at risk for clinical denials before submission.
  • Automating internal audit processes for billing compliance.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Organizations looking for a tool primarily for managing post-submission denial appeals.

💻 Platforms

Web API

🔌 Integrations

Integrates with billing systems to pull pre-payment charge data. Audit API for custom data extraction.

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Standard tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ SOC 2 Type 2 ✓ HITRUST

💰 Pricing

Contact for pricing
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