Guru Auditor

Product Overview

Medical Coding errors can be a jeopardizing factor for organizational claims and revenue. Pena4’s Guru Auditor is the ultimate cloud-based solution for comprehensive medical coding audits. Navigate the complexities of claim reimbursements with unrivaled scope of tackling audits across diverse patient categories, procedures, diagnoses, and code sets. Guru Auditor empowers businesses to uncover discrepancies with precision.

With streamlined efficiency, Guru Auditor enhances agility of the cloud, and the intuitive interface makes audit management, documentation, and reporting effortless. Our team of seasoned coding professionals, auditors, and compliance specialists have a deep understanding and expertise infused with the platform performing accurate medical coding and gathering intelligent insights.

It has a very functional interface for monitoring the progress of all ongoing audits and generates detailed insights on coding accuracy. As we reached a milestone of 35 audit completions, Guru Auditor enables efficiency in audit management. It also offers actionable areas for improving case accuracy at the individual coder level.

Key Features

Creating INP/OP audits using an Excel data source.
Case assignment and closure through a workflow involving Administrators, Auditors, and Quality Analysts.
Code auditing across diagnosis (ICD-10-CM, with POA), procedure (ICD-10-PCS, HCPCS/CPT with Modifiers & APC codes), and other codes sets (DRGs – MS & APR and Weights, HCCs, Facility and Professional E&M codes).
Health System/Client specific configurations for custom audit fields.
Custom Dashboards for Auditors, Quality Analysts, and Admins.

Reports
Post Audit Worksheets in PDF format
Detailed Excel Report on case accuracy
Executive Summary Report
Individual Coder Performance Report
Configurable role-based access restrictions.
Archival of completed audits.

Guru Auditor’s Unique Offerings

Audit Management: Monitoring the progress of all audits is made easy thus ensuring the timely closure of audits.
Process Validation: Numerous checks and balances placed at various stages in the case completion workflow significantly reduce human error.
Gap Identification: Incredibly detailed coding accuracy insights help with identifying the improvement areas for individual coders.
Up-to-Date Codes: The availability of codes for auditing is based on patient admit/discharge dates.
Intuitive User Interface: User-friendly interface with multiple options like drag and drop of codes, easy drill down on dashboards, etc.
Highly Configurable: Monitoring the progress of all audits is made easy thus ensuring the timely closure of audits.
Audit Management: Audit setups can vary significantly based on client or health system requirements.

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Who We Serve

Medical Coding Agencies

Medical coding plays a crucial role in the healthcare system, as it involves translating medical procedures, diagnoses, and services into universally recognized alphanumeric codes. These codes are essential for billing, insurance claims, and maintaining accurate patient records.

Hospitals

Product Overview

Key Features

Guru Auditor’s Unique Offerings

Schedule a Call with Our Experts Today!

Who We Serve

Medical Coding Agencies

Hospitals

Physician Offices

Our Offerings

Health Information Management

Revenue Cycle Management

Medical Coding Audits & Assessments

Compliance

Medical Billing

Virtual Assistant

C.O.R.I.S.

H.I.M. & Revenue Cycle Consulting

Medical Coding

Continuing Education

H.I.M. & Revenue Cycle Staffing

C.D.I. Services

C.D.M. Audits & Maintenance

Central Learning (CL 1.0)

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Guru Auditor