The Benefits of Automating Your Medical Claims Audit

Updated on January 27, 2021

Implementing an automation process may seem like a daunting task, but it’s one where you will soon reap the rewards.

Auditing software can be designed to carry out the same audit process that a human would, except that, unlike a human, software won’t get fatigued, and it won’t make mistakes. Software can also power through data at an astonishing rate meaning that more claims can be checked in a shorter amount of time.


Possibly the biggest selling point for automation is accuracy. If a human being has to sit and work through thousands of lines of data, at some point, they are going to get tired, hungry, or distracted, and their work may not be as accurate – no matter how diligent they are. This can mean that audits need to be double-checked or that incorrect conclusions are drawn.

Medical claims auditing software doesn’t get tired; it simply executes the commands that it has been programmed to execute. This means that any discrepancies that the software finds will always be correct.

You can further automate your audit by working with a third party on parts of the process where a human eye is required. By working with a third party, you can secure the services of auditors with a lot of experience in the field, working together as part of a team.

Potential savings

According to Healthcare Finance News, there is a potential for $11.1 billion to be saved annually through the automation of healthcare claims related to business processes. It’s estimated that $9.5 billion of this could be saved by providers.

The scope for savings increases yearly. The more transactions are processed through online portals and websites, the higher the potential for saving. 

As soon as data is being captured in an online format, there is the potential for it to be fed into a system that can automatically audit the information. 

If your business is capturing data online, there is a potential for you to save a lot of money by automating some or all of the process.


The main way that automating your audit process can save you money is through time. Audit software can process thousands of rows of data at a time, which is something humans just can’t do. 

Forbes estimated that businesses could save $4 billion annually through automation. This isn’t just through time saved, either. By passing on processes that can be automated to software solutions, you free up your human employees to work on more creative endeavors that can benefit your business in hundreds of untold ways.

Higher discovery rate

If you are a large business, it just isn’t possible for a human being to audit all of your system’s claims.

By working with software, not only can you look at more data, but you can choose to audit specific segments of your data to locate patterns and trends. By working in this way, you can quickly identify problem areas and work to resolve issues at their source.

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The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.