Problem Statement

Inbound payer audit requests have to be read, fulfilled with the right records, and returned before the audit deadline, and doing this manually is slow and easy to backlog. Each audit letter has to be interpreted to identify what's requested, the matching records downloaded, and then uploaded to the payer or printed for mailing. A late or incomplete audit response risks the payer recouping payment on the records in question.

Automation Solution

This automation reviews payer audit letters, downloads the requested medical records, and uploads them to the payer portal or prepares them for mailing.