NANO MAS

NANO Medical Auditing Solution

An audit that reads everything, not a sample of it

A manual audit reads a sample and infers the rest. That is not a criticism of auditors — it is arithmetic. Nobody reads a year of claims by hand, so the sample gets smaller as volume grows, and confidence shrinks with it exactly when the exposure is largest.

NANO MAS reads the population. Every claim, every code, every provider — which turns an audit from a periodic exercise into a standing control, and turns the auditor from a sampler into someone who investigates what the system already found.

Internal audits of billing and coding are not optional in a DRG or classification-based environment: the record is what you will be measured on, and an audit is the only way to know what it says before someone else reads it.

Audit Management

Audit workflow, evidence and findings in one place, so a finding is traceable back to the claim and the record that produced it — which is what makes it defensible when it is challenged.

Audit CPT®, PCS, HCPCS, ACHI, ICD9 and ICD10 Codes

Cloud-based, no local install

Real-time customisation and claim alerts

Customizable Audit Procedures

Analytics Management

The models look for what a sample cannot show you: a provider whose code mix drifts from their peers, a procedure that appears more often than case mix explains, a pattern that only becomes visible across thousands of claims.

Provider and code-usage outliers, surfaced rather than searched for
Billing trends — the common ones, and the ones that should not be common
Providers benchmarked against internal and national peers

Audit Service Management

Run it yourself or hand it to our auditors. Either way the same evidence trail comes out the other end, which matters on the day a finding is disputed.