• Take control of your claims audit and denials process
    and protect your revenue.

    • As reimbursements for healthcare services shrink, it's essential you get paid on every rightful claim. 

      Compliance 360 Claims Audit and Denials Manager provides everything you need to take command of the audit and denials process and improve net revenue capture. 

      • Talk to an advisor

        Find out how we help organizations like yours.

      • SOLUTION OVERVIEW

        • Improve workflow efficiency and root cause analysis to maximize revenue using a single, highly configurable governance, risk and compliance software solution
        • Increase volumes while reducing cycle times for claims audit and denials by automating the end-to-end process for hospital workers and healthcare providers

         

        • Compliance 360
          Enterprise Risk Manager

        • Managing claims audits
          in Compliance 360

        • Managing claims denials
          in Compliance 360

        • Attacking medicare advantage
          and commercial payer denials

        • BENEFITS FOR YOUR ORGANIZATION


          Manage claims audits from any payer


          Claims Audit and Denials Manager automates core processes across departments so your team can identify, analyze, and prioritize denied claims, streamline responses, and maximize revenue.

          Manage claims under audit from any payer including Medicare RAC, Medicaid RAC, MIC, MAC, ZPIC, and commercial payers.



          Put analytics into action for intelligent process improvement


          Configurable workflows provide a “virtual coordinator” to keep the internal evaluation and response process moving quickly. Work smarter by automating alerts, enforcing employee accountability, and ensuring appeals deadlines are met. Real-time graphical dashboards and reports give managers clear visibility into trends and problem areas.

          Gain actionable intelligence into root causes of denials and reduce your organization's financial exposure.



          Enable enterprise-wide healthcare compliance and risk management


          Integrate revenue cycle management into your broader GRC plans. A holistic approach to compliance is mandatory in today's demanding healthcare environment.

          Compliance 360 empowers hospitals and healthcare systems to address rising governance and enterprise risk management requirements of Boards, investors and regulators.

          • A leader in The Forrester Wave™

          • Combating managed care denials

          • Compliance 360
            overview

          • Changing the compliance culture
            at Baptist Health System

          • Combating managed care denials
            2: tips for an effective strategy

          • Find out more

            Talk to an Advisor