AI-Assisted Document Checking
Organise claim documents, run configured checks and highlight items that may need correction.
AI-Assisted Claim Pre-Audit Platform
Smart Pre-Audits. Better Claim. Outcomes
Review healthcare claim documents before submission with a structured, AI-assisted pre-audit workflow designed to help hospitals identify gaps, improve documentation quality and reduce avoidable errors.
Built for healthcare teams
Hospitals
Billing Teams
Certified Claim Professionals
Audit Teams
Hospital Groups
Hospitals
Billing Teams
Certified Claim Professionals
Audit Teams
Hospital Groups
About Us
More clarity before claim submission
AuditMedix is a healthcare claim pre-audit solution concept focused on helping hospital teams organise records and perform consistent checks before submission. It supports the review process; it does not replace clinical judgement, official scheme rules or payer decisions.
Checklist-based document verification
Role-based access and review workflow
Clear correction notes and audit history
Human oversight for final review decisions
Review with confidence
Illustrative status categories to help teams organise their next steps. Final decisions remain with authorised reviewers and relevant payers.
GREEN
Checks completed
YELLOW
Review needed
RED
Action required
AuditMedix
Smart Pre-Audit. Better Claim Outcomes.
Illustrative categories only. AuditMedix supports documentation review; it does not guarantee claim approval or replace authorised professional decisions.
Our Vision
A more transparent future for healthcare claims
Our vision is to support hospitals with a more organised, technology-enabled claim review process—helping teams identify documentation gaps earlier, strengthen review consistency and focus more time on patient care.
- Make pre-audit workflows clearer and easier to follow
- Encourage complete, well-organised claim documentation
- Combine technology support with professional human review
Our Mission
Better preparation. Clearer review.
We aim to provide practical tools that help claim teams spot potential gaps before submission, with appropriate human oversight and respect for applicable guidelines.
The Challenge
Healthcare Claims Require Detailed Documentation
Claim processing can involve a large number of medical, administrative, and supporting documents. AuditMedix helps healthcare teams identify potential issues earlier - allowing them to review and address them before submission wherever appropriate.
Missing Information
Incomplete claim forms, absent supporting records, or overlooked attachments can slow down claim review and create avoidable follow-ups.
Inconsistent Records
Mismatched dates, differing diagnosis codes, or conflicting entries across documents may raise questions during claim assessment.
Documentation Gaps
Missing discharge summaries, investigation reports, or prescriptions can leave reviewers without the evidence a claim requires.
Please note: AuditMedix findings are assistive in nature and require professional verification by authorized personnel before any decision is taken. AuditMedix does not make claim decisions on behalf of any hospital, payer, or authority.
Built for better preparation
Everything you need for a smarter pre-audit
A practical workflow to help teams organise documents, identify missing information and review claims before submission.
AI-Assisted Pre-Audit
Apply configured checks to submitted documents and highlight potential gaps for the audit team to review.
AMS Document Reading
Extract readable text from supported scanned files and PDFs to support faster document review.
Manual Audit Workflow
Enable authorised reviewers to verify findings, add remarks and track required corrections.
Claim Dashboard
View claim status, pending reviews, correction requests and completed audit activity in one place.
Risk Indicators
Use Green, Yellow and Red indicators to prioritise claims that may need additional attention.
Risk indicators
Audit Reports
Generate structured review summaries to help teams communicate findings and next steps clearly.
Pre-Audit Support for Empanelled Hospitals
Ayushman (PM-JAY)
ESIS / ESIC
ECHS
CGHS
Insurance & TPA
Other Payers
LEGAL & SAFETY: PM-JAY, CGHS, ECHS, ESIS, Insurance & TPA names belong to their respective authorities. AuditMedix is not affiliated with or endorsed by these organisations. Coverage, approval and payment are not guaranteed. Final decisions rest with the concerned authority.
Real-Time Challenge • Clean Claims
Specialist Availability is Critical. Denial Prediction Makes it Possible.
Ensuring real-time availability of specialist doctors at the time of claim submission remains a key operational challenge for hospitals.
Real-Time Documentation Check
Accuracy & Transparency
Clean Claim Outcome
Denial Risk • Live Analysis
Documentation Complete
LOW RISK
Specialist Note Missing
MEDIUM
Admission Criteria Gap
HIGH RISK
Illustrative risk indicators only • Final decision with authorized reviewer
Document checks backed by professional review
AI can help flag documentation gaps. Experienced hospital and audit professionals remain central to review and decision-making.
Professional Team Review
Bring structured AI findings and human verification together for a clearer pre-audit workflow.
Subscription Plans
Choose the Plan that Fits Your Claim Volume
Monthly plans based on the number of claim files your team reviews - move up as your volume grows.
Basic
50-100
Claim Files / month
For teams beginning a structured pre-audit review process.
- AI-assisted document review
- OCR processing
- Missing document identification
- Green / Yellow / Red risk classification
- Structured audit report
- Email support
Most Popular
Premium
100-200
Claim Files / month
For growing claim teams that need professional audit depth.
Everything in Basic, plus:
- Manual audit by authorized auditors
- Correction observation report
- Re-upload & re-review
- Priority processing
- Centralized dashboard
- Phone + Email support
Premium Advance
200-500
Claim Files / month
For hospital groups managing high claim volumes.
Everything in Premium, plus:
- Dedicated audit manager
- Claim history & analytics
- Custom validation rules
- Dedicated support
All plans include secure document handling. Final claim decisions remain with the hospital. Contact us for custom volume requirements.
How AuditMedix works
From document upload to reviewer sign-off, keep each step clear and organised.
Upload Claim Files
Submit the available claim documents through the authorised hospital workflow.
Extract & Validate
AMS and configured checks help identify missing or inconsistent information.
Review Findings
AI suggestions and manual reviewer checks bring attention to items needing action.
Resolve & Report
Track corrections and prepare an audit summary before the claim moves forward.
Who Can Use AuditMedix
Designed for Every Team in the Claim Journey
Hospitals
Support internal claim documentation and pre-audit activities.
Hospital Billing Teams
Organize and review claim documentation before submission.
Professional Claim Management Teams
Support systematic documentation review and claim preparation.
Healthcare Audit Teams
Manage AI-assisted and manual audit workflows.
Hospital Groups
Create a more consistent pre-audit process across multiple facilities.
Why AuditMedix
Built to Support Better Pre-Audit Processes
Identify Potential Issues Earlier
Help teams identify documentation gaps and inconsistencies before submission.
Improve Audit Efficiency
Assist auditors with repetitive document-review activities.
Standardize Review
Use configurable rules and structured workflows for a more consistent review process.
Improve Visibility
Track claims and audit activities through a centralized dashboard.
Support Human Decision-Making
Provide AI-assisted findings while keeping professional review and decision-making at the center.
Maintain Structured Records
Keep organized audit information and claim history for internal reference.
Security & Access
Designed for Controlled Healthcare Workflows
AuditMedix supports structured access and controlled workflows for healthcare organizations. Organizations should configure security, data retention, access controls, and deployment practices according to their operational, contractual, and applicable legal or regulatory requirements.
Role-Based Access
User Authentication
Controlled Document Access
Audit Trails
Claim History
Administrative Controls
Secure Data Handling
FAQ
Frequently Asked Questions
AuditMedix is an AI-assisted healthcare claim pre-audit and documentation review platform designed to support hospitals and healthcare teams.
No. AuditMedix does not guarantee claim approval, payment, acceptance, or rejection prevention.
AuditMedix can help identify potential documentation gaps and issues before submission. However, claim outcomes depend on the applicable scheme, payer, medical documentation, eligibility, policies, and other factors.
No. AuditMedix is designed to assist auditors and healthcare teams. Professional review and judgment remain important.
Yes. AI-assisted technology can be used to support document analysis, information extraction, and configured pre-audit checks.
Yes. OCR can assist in extracting information from supported documents.
Yes. AuditMedix supports a manual audit workflow alongside AI-assisted review.
Yes. The platform can generate structured audit reports based on the configured workflow and audit findings.
Request a Demo
See How AuditMedix Can Support Your Pre-Audit Workflow
Discover how AuditMedix can help your team organize, review, and manage healthcare claim documentation. Share your details and we will prepare a walkthrough tailored to your claim volume.
AI-assisted review with professional oversight
Structured audit reports for every claim
Role-based access for your whole team
Prepare Better. Review Smarter.
AuditMedix - AI-Assisted Healthcare Claim Pre-Audit Platform.
Smarter Claims. Better Audits. Better Prepared.
Important Disclaimer
AuditMedix provides document review and pre-audit support. It does not guarantee claim approval or replace official scheme guidelines, payer requirements, clinical judgement or authorised human review. Figures are illustrative only. No Govt. affiliation. No guarantee of approval. Patient data via authorized access only, as per DPDP Act 2023.