Healthrise Expands Quality Audit Platform with New Smart Account Selection and Real Time Alerts for Faster Issue Resolution
New capabilities help revenue cycle teams prioritize high-risk accounts, focus audit resources and act on issues before
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Key Facts (At-a-Glance):
- Two new capabilities: Healthrise has expanded its Quality Audit Platform with Smart Account Selection and Real Time Alerts, helping revenue cycle teams identify higher-risk accounts, surface issues earlier and drive faster resolution.
- Risk-based auditing: Smart Account Selection uses configurable risk metrics and data signals to prioritize accounts with specific indicators of financial risk, payer behavior, billing errors or downstream denials.
- Focused audit resources: Reviewers and managers can filter and prioritize accounts based on their audit objectives, helping teams spend less time on low-risk accounts and focus limited audit capacity where it can have the greatest impact.
- Automated prioritization: Selection logic and risk models can run automatically, keeping prioritized accounts available for ongoing review and helping teams identify issues sooner.
- Real time issue resolution: Real Time Alerts immediately notifies the team member responsible for an account when an auditor flags an issue, delivering the flagged account and auditor’s comments by email and in the application.
- Closed-loop workflow: Team members can correct flagged issues and mark them resolved, while the notification, response and resolution are automatically documented in the monthly assessment, creating a direct path from identification to correction.
- Proactive revenue cycle performance: Together, the capabilities help shift quality auditing from a retrospective review process to a more proactive workflow that can address issues before they become downstream denials, rework or lost revenue.
FARMINGTON HILLS, Mich., Sept. 22, 2026 (GLOBE NEWSWIRE) — Healthrise, a healthcare consulting and technology firm, today announced the expansion of its Quality Audit Platform (QAP) with Smart Account Selection, a new capability designed to help health systems move beyond random account sampling and prioritize the accounts most likely to require attention.
Smart Account Selection uses configurable risk metrics and data signals to surface accounts with specific, evidence-based reasons to be reviewed. These signals can include elevated financial risk, payer-specific behavior and indicators associated with billing errors or downstream denials.
Reviewers and managers can select and filter by risk metrics aligned to their specific audit objectives, creating focused audit populations without relying on manual account selection. This helps teams spend less time on low-value reviews and more time investigating accounts with greater potential financial or operational impact.
“Revenue cycle teams can only look at so many accounts in a day, so every account should have a reason to be there,” said Tiffany Naughton, Principal Data Scientist at Healthrise. “Smart Account Selection puts the accounts with the greatest risk and potential impact in front of reviewers first, helping teams find issues faster, see patterns sooner and get more value from every audit. When front-end and back-end teams can act on risk-flagged accounts quickly and with confidence, they stop chasing problems after the fact and start preventing them at the source. That is how quality audit becomes a true driver of revenue cycle performance.”
Selection logic and risk models can run automatically, allowing prioritized accounts to be available for review on an ongoing basis. This helps shorten the gap between when an issue occurs and when it is identified, giving revenue cycle teams an opportunity to address problems before they contribute to downstream denials, rework or additional financial impact.
The approach can also help organizations identify patterns across payers, account types and staff. When multiple accounts share a common risk characteristic, audit findings can provide actionable insight into where billing issues are occurring and where targeted coaching, training or process improvements may have the greatest return.
The new capability reflects a broader shift in healthcare quality auditing from retrospective, random-sample reviews toward more targeted, proactive approaches. While random sampling can provide a broad view of performance, it can also give equal weight to low-risk and high-risk accounts. Data-driven selection allows health systems to direct limited audit resources toward accounts with specific risk signals and potentially intervene before issues become denials or rework.
Building on this targeted approach, Healthrise is also introducing Real Time Alerts to help revenue cycle teams move from identifying an issue to correcting it in the same workflow.
When an auditor flags an issue during an account review, Real Time Alerts immediately notifies the team member responsible for the account by email and in the application, including the flagged account and auditor’s comments. The team member can correct the issue and mark it resolved, with the notification, response and resolution automatically documented in the team member’s monthly assessment.
By replacing fragmented handoffs through email, Teams and manual tracking, Real Time Alerts helps close the gap between identifying an error and fixing it, before a claim moves downstream and the issue becomes a denial, rework or lost revenue.
“The point of an audit isn’t to document what went wrong, it’s to stop it before it costs the organization,” said David Farbman, CEO of Healthrise. “Smart Account Selection puts the highest-risk accounts in front of auditors first, and Real Time Alerts gets those findings to the right person while there’s still time to act. Together, they turn quality auditing from a retrospective exercise into a real-time driver of revenue cycle performance.”
Together, Smart Account Selection and Real Time Alerts create a more proactive quality audit workflow, helping revenue cycle teams identify the accounts that matter most, surface issues earlier, focus audit resources where they can have the greatest impact and connect findings directly to the people responsible for correcting them.
To learn more about Healthrise’s Quality Audit Platform and data-driven approach to revenue cycle performance, visit www.healthrise.com.
About Healthrise
Healthrise is a healthcare consulting and technology firm that provides revenue cycle management, electronic health record optimization and strategic advisory services to hospitals and health systems across the United States. Founded in 2012, the company partners with organizations to improve financial and operational performance through customized, data-driven solutions. Healthrise has supported more than 25 health systems and managed over $35 billion in net patient revenue, helping clients strengthen long-term sustainability and care delivery. For more information, please visit www.healthrise.com.
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