The Wellington Group, LLC    The Wellington Group, LLC
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SOFTWARE

Ambulatory Revenue Manager™

AuditNavigator™

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SERVICES

Outpatient Operations Assessment

Clinical Department Improvements

Clinical Department Coding Audit
AuditGuru™ - Feature Specification List
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AuditGuru™

Settings supported:
  • Hospital
  • Clinics
  • Long Term Care
  • Physician Practices
  • Ambulatory Surgery Centers
  • Mental Health


Types of audits:
  • Coding (Inpatient, Outpatient and Physician)
  • Coding Staff Evaluations
  • Clinical Documentation
  • Defense Audits
  • Linked Claim Audits (Institutional and Physician)


AuditGuru™ users:
  • Health Information Management
  • Compliance
  • Revenue Cycle
  • Nurse/Coding Auditors
  • Case Management
  • Billing Office
  • Consultants, External Auditors, Contractors


Features:
  • Claim repository based on submitted claims (837 files)
  • Initially loaded with historical claims
  • Automated uploads of current claims
  • User defined selection of the audit population and sampling methodology
  • AuditAssist automatically edits claims
  • Performs over 3,000 charge capture and compliance edits on outpatient claims
  • Identifies potential RAC issues
  • OCE and MCE editing
  • ICD-10 Training Utility
  • Compare coding of original vs. audited claim
  • Calculate change in payment
  • Medicare – DRGs, APCs (OP and ASC), physician fee schedule
  • Fee schedule payers
  • Percent of charge payers


AuditGuru™

 

The Wellington Group, LLC
6133 Rockside Rd, Suite 205
Independence, OH 44131
Phone: 216.525.2200
Fax: 216.525.2201
Schedule an online demonstration