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Medical Coding Auditing Tool
GURU Auditor

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Product Overview

Pena4’s Guru Auditor is the ultimate cloud-based solution for comprehensive medical coding audits, designed to navigate the complexities of claim reimbursements across diverse patient categories, procedures, diagnoses, and code sets. Guru Auditor assists businesses to uncover discrepancies with precision while enhancing efficiency through its intuitive interface, making audit management, documentation, and reporting effortless. Backed by a team of experienced coding professionals, auditors, and compliance specialists, the platform ensures accurate medical coding and provides valuable insights. With a functional interface to monitor ongoing audits and generate detailed coding accuracy reports, Guru Auditor has successfully completed 35 audits, enabling organizations to improve case accuracy at the individual coder level.

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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 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
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Guru Auditor's Exclusive 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 reduces 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

Who we serve

Medical Coding Agencies

Empowering coding agencies with precision audits and coder performance insights.

Hospitals

Enhancing hospital compliance through comprehensive coding audits and management support.

Physician Offices

Simplifying coding accuracy and audit processes for physician offices to ensure optimal reimbursement.

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This is one of very few vendor relationships I have experienced in my 35 years as an HIM where I truly feel like we are partners with the same goal in mind-quality health information.

Cindy Penner

The Ottawa Hospital

I have had experience with other offshore coding services, and the quality from the Pena4 coders is excellent.

Craig Chase

Catholic Health Services

Very responsive team, expert knowledge, and easy to work with.

John Samuels

Better Health Advisors

Always on point with Turn Around Time requirements.

Lordy Josama

One Brooklyn Health System

Great long-term relationship, able and willing to meet our needs. Great customer service, great support, great outcomes!

Ray Cosner

Mt. Sinai Health System

It has been such a pleasure to work with Pena4 and their team. They have highly educated coders and I do not need to be involved in their internal processes, they know how to get the job done and with great quality.

Bonnie DiAntonio

RWJ Barnabas South

Pena4 continues to deliver high-quality services to our Team. We look forward to maintaining our strong partnership with the Pena4 Team.

Jade Johnson

Mount Sinai Hospital MSH/MSQ

Thank the management team, Arnab, Navin, Caroline, and the entire support team for their continued support and dedication to BronxCare Health Systems.

Valerie Oselmo

BronxCare Health System

Pena4 staff was helpful and accommodating to our professor and students' needs.

Dasantila Sherifi

Rutgers University

Implementation is a 2-way street and Pena4 keeps up its end. They provide great service with involved and attentive operations leaders.

Craig Chase

Catholic Health Services

Love the Team! Deb, Bernie, and Shelley are extremely knowledgeable, friendly, and especially pleasant to work with!

Sonia Shiels

Joseph Brant Hospital

We hired HIMonCall to assist with coding to meet our mandated fiscal year deadlines. We were able to meet this deadline successfully with the help of these contract coders and the work was delivered on time, as promised.

Monique Rasmussen

Providence Health Care