Auditing medical bills at your health plan operator is essential to optimize costs, be able to see what works and what doesn't, and analyze and improve the necessary processes.

In addition automated audit of medical bills prevents fraud, controls supplies, avoids excessive or unnecessary purchases, practically eliminates glosses, thus increasing transparency and reliability for users and related providers.

With that in mind, we have brought here 4 essential tips to help you with this essential service for good management, which is the audit of medical bills. Continue reading!

4 steps to optimize medical bill auditing

Auditing medical bills is important for health plan operators to act rigorously, maintaining or improving the quality of care and minimizing or eliminating the risk of misappropriation of resources, fraud, and waste in processes.

1st step – Monitor supplementary health indicators

To have supplementary health indicators to monitor and evaluating the quality of services provided by operators is one of the advantages of carrying out the medical bill audit automatically in your healthcare provider.

The IDSS (Supplementary Health Performance Indicators), for example, is a tool that aims to verify the results of the performance quality assessment of supplementary health operators. In addition, you can (and should) also monitor: hospital stay rates, readmissions, non-compliant hospitalizations, deaths and others.

Now think about a medical audit system that allows you to monitor all these indexes and others! With the indicators in hand, the manager can see the real situation of the health plan operator, always keeping it as comfortable as possible.

2nd Step – Use technology and artificial intelligence in the audit process

To achieve speed and security in audit processes, health care providers have been opting for a long time to use technology, which is supported by increasingly better artificial intelligence resources.

When using a medical audit system, requests for authorizations for procedures, exams and consultations are carried out automatically, transparently and without using paper, automating and facilitating the entire medical bill audit process.

Based on all the data storage that the system provides, it is possible to apply artificial intelligence in an optimized way for your operator through the Medical Accounts Audit System – SAUDI for example, which already allows a reduction of up to 30% in assistance and operational costs, that are:

• reduction of undue charges due to operational errors,
• reduction of structural costs;
• makes it possible to accurately analyze variations in the provision of payments to service providers, in addition to other benefits.

3rd step – Have transparent processes

With the powerful tools, analyzes are carried out automatically by the medical bill audit system, which enables total transparency, as the bills are clear and available for consultation throughout the payment process.

One benefit of this is the monitoring of online disallowances, which can be resolved in a short space of time to receive the actual amount due.

4th step – Choose an intuitive and easy-to-use medical audit system

Designed to facilitate and optimize the audit of medical bills, we recommend that you familiarize yourself with the SAUDI system, which has a very intuitive interface, which makes learning and handling much easier for employees and managers of healthcare providers.

Furthermore, it is possible to monitor all information in a beneficiary's hospitalization process and remotely manage which patients should be monitored.

SAUDI is concerned with both the manager and the beneficiaries of healthcare assistance, and is therefore prepared to provide the best information support to the medical auditor or nurse at the time of the audit.

Request a free analysis with one of our experts and guarantee the Medical Audit System used by the largest healthcare providers in Brazil, which in addition to reducing costs, allows managers, providers and patients to have better interaction.

As SAUDI – Medical Account Audit System, your health plan operator will be well supported, with the medical audit fully automated, monitoring results and reducing costs. Contact us!