Revolutionizing Audits

for Health Plans

Streamline Audit Processes || Ensure Compliance || Uncover Audit-Driven Insights
with Claims Audit Tool Set [CATS]

Healthcare Audits

The Challenge:

Audits in health plans can be overwhelming. With departments like Claims, Compliance, Utilization Management, Access, and Crisis Services working in silos, the process often involves:

  • Manual and time-consuming workflows.
  • Fragmented data across multiple systems.
  • Increased risk of errors and compliance issues.

The Solution:

Eliminate the hurdles with CATS. CATS simplifies and unifies the audit process for health plans by breaking down departmental silos and automating workflows. Our intelligent platform centralizes audit data, streamlines operations, and enhances accuracy—reducing manual effort, minimizing errors, and ensuring compliance with regulatory standards. With CATS, health plans can conduct audits with greater efficiency, transparency, and confidence.

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Key Benefits

Enhanced Efficiency

Save hours with automated workflows, reducing manual effort and bottlenecks.

Improved Accuracy
Minimize costly errors with real-time data validation and standardized processes.
Compliance Confidence
Stay ahead of regulatory requirements with built-in guidelines tailored for health plans.
Customizable Dashboards
Gain actionable insights with data visualizations designed for Claims, Access, Crisis Services, and more.
Streamlined Collaboration
Foster seamless communication and coordination across departments, ensuring a unified approach to audits.
AI-Powered Insights
Leverage artificial intelligence to detect trends, predict risks, and suggest corrective actions proactively.
Automated Reports
Generate audit reports instantly, reducing the time spent on manual documentation.
Secure Data Management
Ensure compliance with industry security standards, keeping audit data protected and accessible.

Audit Intelligence

CATS (Claims Audit Tool Set) learns from past audits and recommends new audit areas based on historical trends and risk factors, ensuring a proactive approach to compliance and quality assurance.

Create and manage audit schedules with ease. This feature allows users to set up recurring audits at specific periodicities and automatically assigns them to designated auditors, ensuring a structured and efficient workflow.

CATS (Claims Audit Tool Set) incorporates an advanced sampling mechanism, balancing the proportion of clean claims against edits and adjustments. This ensures a more representative audit sample, improving accuracy and compliance insights.

Ready to Simplify Your Audit Process?

Discover how CATS (Claims Audit Tool Set) can revolutionize your audit workflows. Contact us today to schedule a personalized demo.

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