Next-generation technology supports Medicare Advantage Organizations (MAOs) as they navigate regulatory audits

Traditional, manual auditing processes that utilize spreadsheets or homegrown databases are prone to errors, data loss, or even data corruption. With thousands of lines of coding data, the manual analysis and selection of records for a risk adjustment audit is nearly impossible.

The Health Language Coder Workbench Regulatory Audit Module integrates clinically-trained AI technology to ensure that every chart submitted is optimized for compliance and accuracy, with an average of 5-7% additional codes identified.

Embedded logic enables you to prioritize charts that need review, improving the coder efficiency by 25%+ and ensuring the best dates of service are submitted to ensure the highest validation rates to mitigate the impact of extrapolated repayment policies.

Leave manual audit workflows and inefficiencies in the past. Request a demo to see how to take your audit processes from a regulatory requirement to a strategic advantage.

Request a Regulatory Audit Module demo

The Health Language Regulatory Audit Module

The Health Language Coder Workbench Regulatory Audit Module is a revolutionary project management tool designed to optimize the health plans' response to regulatory audits. Our clinically- trained AI efficiently and accurately captures all HCCs from audited medical records and recommends the best charts to submit for the highest validation rates to mitigate the impact of repayment penalties. 

Understanding Risk Adjustment Audits: OIG and RADV  

RADV and OIG audits are not merely regulatory hurdles but opportunities to fortify the foundations of risk adjustment compliance. 

Webinars to help you prepare for an OIG or RADV audit 

Latest resources on risk adjustment compliance 

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