AUDiT iQ

Combining advanced software technology with time-tested audit methodologies, BMI is proud to introduce AUDiT iQ version 2.1 for use by health care claims administrators, employers, and employee benefit advisors.

AUDiT iQ is a comprehensive claims and eligibility audit tool centered around our proprietary analytical engine FiLTER iQ and its modules: independent functional versions of AUDiT iQ tailored to your specific audit needs.

AUDiT iQ Medical

The Medical module comes complete for auditing all aspects of a medical health plan and its associated claims data.

A comprehensive set of medical codes are included with the software and are fully integrated into the auditing process. These code sets include: AMA CPT®, AMA HCPCS, AMA ICD-9, and CMS Revenue codes.

The Medical module is based on over 80 categories that have been pre-tuned and configured out-of-the-box to use the most appropriate medical codes available. In addition, each category can be configured to capture benefit design metrics related to deductibles, co-insurance, in-network / out-of-network payment levels, dependents, maximums based on occurrences or incidents, and others. Some examples of audit categories include:

• Duplicates
• Medical Necessity
• Potential Other Party Liability
• Excluded Services (acupuncture, cosmetic procedures, ...)
• Limited Services (chiropractic, physical therapy, ...)
  

Other forthcoming modules include:

· AUDiT iQ Rx
· AUDiT iQ Dependent Eligibility
· AUDiT iQ Dental

For availability and to learn more about AUDiT iQ, please contact:

Will Baker, V.P. Marketing and Sales
(800) 826-7041 x23

Jim Matthews, Chief Technology Officer
(800) 826-7041 x19