Revolutionizing Audits

for Health Plans in Michigan

Streamline processes, ensure compliance, and save time
with CATS (Claims Audit Tool Set)

: 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 :

CATS (Claims Audit Tool Set) eliminates these hurdles by automating and streamlining audit processes across departments. Our platform empowers health plans to work smarter, not harder.

Key Benefits of CATS
(Claims Audit Tool Set)

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 Report Generation

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.

 
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.