Identify high-risk accounts, target reimbursement opportunities, and build precise audit samples in seconds— not hours
Sampling & Randomization
Effective auditing starts with powerful selector tools. ReviewMate equips auditors with intuitive, flexible selection capabilities designed to support virtually any audit scenario. With advanced query parameters built into every audit workflow, auditors can quickly identify and extract the precise accounts they need from large datasets with accuracy and confidence.
In addition to targeted filtering, ReviewMate includes randomized account selection to support unbiased sampling, reduce the risk of oversight, and help maintain accurate, compliant records.
Beyond manual selection, ReviewMate enables organizations to automate queries and sampling workflows based on their unique audit requirements. Auditors can configure recurring selections, automate routine audit tasks, and streamline findings population — reducing manual effort, improving consistency, and increasing overall productivity. With just a few clicks, repetitive audit processes can be transformed into efficient, repeatable workflows.
Intelligent Sampling
ReviewMate Sample Selector was designed to give audit and quality management teams a fast, intuitive way to generate both random and targeted patient account samples for coding review. Built to support complex healthcare auditing workflows, ReviewMate provides one of the industry’s most advanced and flexible account sampling solutions.
Using the ReviewMate rules engine, organizations can create and manage customized logical rules tailored to their specific audit objectives. Audit samples can be generated based on timeframes, DRGs, reimbursement thresholds, coding patterns, payer criteria, and countless other combinations of coding and compliance conditions.
The platform’s advanced selection engine applies sophisticated logical operations to organize, combine, and refine patient account groups with precision. This allows teams to build highly focused audit populations using multiple variables and layered conditions, helping auditors quickly identify high-risk accounts, improve review accuracy, and streamline audit preparation.
Statistically Valid Random Sampling
Random sampling helps ensure that audit results accurately reflect the performance and characteristics of the broader patient population. Selecting a representative sample is essential for evaluating coding accuracy, provider performance, compliance trends, and overall audit integrity.
ReviewMate uses a sophisticated mathematical randomization algorithm to generate unbiased sample selections, helping organizations create statistically reliable audit populations with confidence and consistency.
Automated & Workflow-Driven Audit Sampling
Healthcare coding audits are an ongoing process, which makes automated sampling essential for maintaining consistency and efficiency. ReviewMate Sample Selector enables organizations to automatically generate randomized or targeted audit samples on a schedule that fits their operational needs — whether daily, monthly, quarterly, or annually.
One of the most common workflows is automatically selecting a defined number of random patient accounts per coder at recurring intervals. ReviewMate can intelligently determine whether selected accounts should be added to an existing review or routed into a newly created audit based on configurable review family and workflow rules.
Beyond sample selection, ReviewMate supports customizable audit workflows that manage coding revisions throughout every stage of the review lifecycle, including both pre-bill and post-bill audits. For example, if an initial reviewer updates findings within the EMR or encoder and escalates the case for a secondary CDI review, the revised account can automatically follow a separate workflow path and be routed to the appropriate reviewer.
Comprehensive revision controls ensure every change, update, and review action is tracked, providing complete visibility into the audit history of each patient account.
Key features of Sample Selector workflows include:
- Managing patient accounts within a review through actions such as Copy, Move, Delete, Skip, and Update, driven by customizable triggers.
- Automatically assigning reviewers based on departments, coders, or other defined criteria.
- Generating customizable email notifications triggered by specific workflow events.
- Creating customizable tasks for reviewers and audit managers.
Manual Sampling
If an electronic interface isn’t available from your EMR or abstracting system to move the audit records into ReviewMate, manually uploading your patient accounts into our Sample Selector module is always an option. All of the same great features and workflows remain available.