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Over $300,000 in Savings
Implementing Compliance Risk Analyzer® at an Academic Institution
Compliance Risk Analyzer: Medical Coding Audit Software
Proactively Managing Compliance Risk & Maximizing Revenue Integrity
Healthcare compliance risks move fast, and every claim counts: Precision and preparedness are non-negotiable. VMG Health’s Compliance Risk Analyzer® offers cutting-edge solutions designed to safeguard your revenue and minimize regulatory exposure associated with CPT, DRG, and APC billing.
Compliance Risk Analyzer transforms claim patterns into actionable predictions by analyzing similarities between audited and clean claims. Organizations can leverage these predictive insights and risk-adjusted reference models to focus resources where the compliance risk—and the opportunity for impact—are greatest.
Advanced Analytics That Deliver
- Coding Risk Analytics
- Optimize risk-based audits and identify services and providers most at risk before payers or federal enforcers take action.
- Review all billing activity.
- Protect your revenue and reclaim lost dollars by detecting under– and overcoding.
- Coding Audit Management
- Respond to audits faster with smart sampling tools that build your claim selections quickly and defensibly.
- Stay on top of multiple audits with tracking and automated chart reviews that show you exactly where each project stands and what needs attention.
- Instantly get the reports you need, from detailed provider results to high-level summaries for leadership.
A Seamless Audit Workflow Backed by Experts You Can Trust
Compliance Risk Analyzer transforms risk-based auditing into a seamless process. With built-in chart review and reporting tools, our solution delivers organized, actionable insights that empower your compliance team and elevate the entire audit process.
- Analyze provider-specific billing profiles.
- Identify high-risk services and providers.
- Generate targeted audit plans in just a few clicks.
- Get ongoing support from the experts behind the solution.
Key Features of Compliance Risk Analyzer®
Compliance Risk Analyzer is HITRUST CSF Certified. HITRUST r2 Certified status demonstrates that CRA, hosted by Microsoft, has met key regulatory and industry-defined requirements to appropriately manage risk.
- Specialty-Specific Precision
Compliance Risk Analyzer uses millions of real-world claims, both passed and failed audits, to benchmark your organization. With specialty-specific cohorts refined to the individual CPT® code and DRG level, you get true apples-to-apples comparisons that uncover risks unique to your organization.
- Predictive Risk Targeting
Compliance Risk Analyzer assimilates and compares large volumes of billing data—including CPT, DRG, and APC claims—against patterns commonly flagged by auditors to help you identify discrepancies before regulators do. This makes it possible to spot potential issues before regulators do, helping you reduce exposure and stay audit-ready.
- Beyond Benchmarking
Unlike standalone tools, Compliance Risk Analyzer is a complete solution—with analytics and audit planning, chart review, reporting, and even expert-led education. Compliance Risk Analyzer delivers the full cycle of compliance risk management in one platform.
- Proven ROI
Compliance Risk Analyzer drives measurable value, reducing audit labor and repayments and recovering undercoding revenue. Per 1,000 providers, we estimate over $700,000 in undercoding identified annually.
- Hands-On Support
Our team of seasoned compliance specialists bring years of hands-on experience to interpret results, guide targeted audit plans, and provide education.
Why Healthcare Organizations Need Coding Audit Software
The Compliance Risk Analyzer medical coding audit software transformed an academic institution’s audit process into a more efficient, cost-effective strategy by narrowing audits to only those flagged by the software’s findings—eliminating unnecessary reviews and drastically reducing false positives. The results were significant: retrospective baseline probe audit costs dropped by $170,000, and post-audit review expenses fell by another $140,000. Beyond the financial savings, the software also strengthened compliance by proactively identifying high-risk codes and modifiers most likely to draw CMS or private payer scrutiny.
Complimentary Evaluation
Instant Provider Risk Assessment
Take the first step toward safeguarding your organization through our preliminary risk assessment.
“Our organizations’ use of the CRA has also evolved such that the Compliance Risk Analyzer has become the backbone and centerpiece for our endeavors related to risk-based monitoring, auditing, and evaluating billed professional services.”
– Executive of a major regional health system
Assess Any Provider’s Coding Risk Based on Medicare’s Utilization
VMG Health brings unmatched healthcare expertise to every solution. Compliance Risk Analyzer puts our industry expertise to work, empowering your organization with the technology and insight to manage compliance risk and capture every dollar owed.
Stay ahead of auditors and outperform competitors. Contact us today to learn how to turn compliance into an advantage.
How Does Compliance Risk Analyzer Work?
Current Procedural Terminology (CPT) © 2025 American Medical Association. All rights reserved.
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