RADV audits, OIG reviews, and CMS compliance requirements demand documentation you don't have time to build manually. Pamastay gives your compliance team continuous monitoring and audit-ready exports.
Manual compliance monitoring doesn't scale. Auditors move faster than spreadsheets.
You learn about compliance gaps when the audit letter arrives. By then, you're scrambling to pull documentation and explain patterns you didn't know existed. CMS RADV audits are expanding in scope and frequency.
When auditors ask "how do you monitor for X?", you need to show process documentation, detection logic, and historical evidence. Building this retroactively is painful.
Claims data lives in your data warehouse. Provider info is in credentialing. Audit findings are in spreadsheets. Without a unified platform, you can't build predictive models or create feedback loops that improve over time.
You know RADV audits are a continued OIG priority, but you don't know which providers or HCCs are most likely to be sampled—or which would fail documentation review.
Monitoring individual provider compliance across your network is a full-time job—or several. OIG compliance guidance expects organizations to have effective monitoring systems in place.
CMS updates, OIG work plans, state-specific requirements—the compliance landscape shifts constantly. Keeping your monitoring current is a moving target.
Continuous monitoring and audit-ready documentation that proves you're doing the work.
Automated surveillance of claims patterns, coding accuracy, and billing compliance. Know about issues before auditors do—not after.
One-click generation of documentation packages for RADV, OIG, CMS, and state audits. Complete with detection logic, findings history, and remediation tracking.
Identify which HCCs and providers are most likely to be sampled and which would fail documentation review. Prioritize pre-audit remediation.
Individual compliance scores for every provider in your network. Coding accuracy, billing patterns, and flagged issues—all in one view.
Pre-built outlier detection for common compliance requirements plus the ability to configure thresholds for your specific policies and risk areas.
Ask questions in plain English and get answers from your compliance data. AI-powered investigation without writing queries.
See how Pamastay gives your compliance team continuous monitoring and documentation that proves you're doing the work.