For Health Plans
Keep post-pay audits moving without managing retrieval site by site.
Datavant manages medical record retrieval across one coordinated workflow, helping Payment Integrity teams reduce manual provider outreach, identify request issues earlier, maintain clear operational visibility, and reconcile delivery and billing with greater confidence.
Less provider chase
Earlier issue identification
Clearer audit oversight
Simpler delivery and billing reconciliation
Medical record retrieval can become the work behind the audit.
Payment Integrity teams should spend their time reviewing claims, not coordinating medical record retrieval. When requests are managed provider by provider, staff absorb the calls, faxes, follow-up, status checks, and reconciliation required to keep audits moving.
Audit staff are pulled into provider research, outreach, and follow-up instead of claim review.
Missing information, unsupported locations, and duplicate requests may surface only after avoidable delay.
Leaders lack one dependable view of status, aging, exceptions, delivery, and billing.
Solutions
What a modern Payment Integrity retrieval workflow should provide
One managed workflow reduces retrieval administration and gives teams clearer control from request through delivery and billing.
Reduce administrative work
One coordinated request process reduces provider research, calls, faxes, follow-up, and manual tracking.
Resolve issues earlier
Identify incomplete, unsupported, or duplicate requests before they create avoidable delays.
Maintain audit oversight
See request status, aging, and exceptions without chasing updates.
Reconcile with confidence
Follow each request from submission through QA, delivery, and invoice.
Orchestrate
Keep every request moving
Track request status, aging, and exceptions in near real time through Chart Compass.
Early match feedback and duplicate checks help reduce dead-end work and unnecessary provider outreach.
Intake
Centralize supported Payment Integrity requests through one intake process.
Match and route
Use managed matching, routing, and duplicate checks to reduce dead-end work and unnecessary provider outreach.
Monitor
Track status, aging, and exceptions in near real time through Chart Compass.
Deliver and reconcile
Use request-level traceability to connect QA, delivery, billing, and invoice questions, supported by a dedicated program team.
Support product-approved post-pay audit requests
Use the managed workflow for DRG validation and other Product-approved post-pay audit record requests.
Claim validation
DRG validation and Product-approved post-pay audit record requests
Audit readiness
Program oversight across request status, aging, exceptions, and escalations.
Strengthen your payment integrity workflow
See how Datavant can help your team retrieve more complete clinical records, reduce manual work, and act sooner.