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Compliance Risk Analyzer: Medical Coding Audit Software
What is Compliance Risk Analyzer® (CRA)?
VMG Health’s Compliance Risk Analyzer® is a medical coding audit software that uses predictive analytics and Medicare claim benchmarking to identify coding and billing risks across CPT, DRG, and APC billing. By analyzing patterns between audited and non-audited claims, the platform helps healthcare organizations prioritize high-risk providers and services, reduce regulatory exposure, and protect revenue integrity.
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Why Healthcare Organizations Need Coding Audit Software
Healthcare organizations need coding audit software to reduce audit risk, protect revenue, and deliver actionable guidance. Without the advanced analytics and benchmarking capabilities that Compliance Risk Analyzer provides, compliance teams are left relying on manual guesswork that limits their ability to perform efficient risk-based audits.
Compliance Risk Analyzer replaces the guesswork by transforming billing data into clear, actionable insights, helping compliance teams identify coding risks, prioritize audits, and reduce false positives.
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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.
Advanced Analytics That Deliver
Strengthen your compliance strategy with Compliance Risk Analyzer’s automated, predictive data analytics, empowering you to proactively identify risks and make more informed decisions with confidence.
- 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.
“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
Risk-Based Audit Software for Compliance Teams
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.
Current Procedural Terminology (CPT) © 2025 American Medical Association. All rights reserved.
Boost Efficiency & Save Costs
Over $300,000 in Savings
Implementing Compliance Risk Analyzer® at an Academic Institution
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