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Welcome to!

Uncover coding and compliance risks and opportunities with CLAIMSauditor®

CLAIMSauditor® is the nation’s newest, fastest and most flexible cloud-based technology that allows compliance teams and other healthcare professionals to find coding, compliance and financial risks and opportunities hidden in their provider claims and other detail data.

This tool goes far beyond EDI data scrubbing. It delivers a cost-efficient, highly effective focused review and audit approach – allowing users to create and apply rules that reveal:

  • RAC issues
  • Medical necessity targets
  • CERT, MIC, MAC, PSC and OIG targets
  • Hospital-acquired conditions and other quality issues
  • Readmission patterns and risk
  • Lost charges (unbilled or under billed services)
  • Under and over payments due to coding and/or documentation errors
  • I-9 to I-10 financial impact

Create queries using rules you select from our library – or develop your own. Select the records, charts or claims having the highest probability for coding, compliance, and quality or billing discrepancies – which can be used retrospectively or concurrently with your billing process.

With CLAIMSauditor® you can develop the reports you need, when you need them.

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