December 05, 2025
Bulk Import File Enhancement and Audit Worksheet Special Character Support
Support for special characters has been expanded across both the Bulk Import File and the Audit Worksheet to ensure full compatibility with real-world data. The Bulk Import process now accepts all special characters in every data field, with updated validation, encoding, and storage handling to ensure proper display.
Similarly, the Audit Worksheet now accepts all special characters across every data entry field in both the reported and audited columns. These enhancements apply to both the Enterprise and multi-account versions of AM+, ensuring that no characters are rejected or truncated during data entry or import.
November 30, 2025
Audit Worksheet Patient Data Prepopulated
The Audit Worksheet now automatically fills in key patient details such as age and place of service whenever that information is available and required by a checklist. This update reduces manual entry, improves accuracy, and speeds up the auditing process.
November 7, 2025
Audit Worksheet – Added wRVU and Calculated Value Based on Claim Type & Modifiers
We have enhanced Audit Manager by including wRVU in addition to the existing tRVU. We also improved the logic to apply the appropriate RVU-based modifiers defined in the fee schedule. For example, if you add extra rows in the fee schedule for modifier 26 and there is a modifier 26 on the encounter line, the corresponding RVU or value will be assigned. You can add rows to fee schedules for any modifiers, such as 51, with values assigned for wRVU, tRVU, non-facility dollar values, or facility dollar values.
When the data elements of wRVU, tRVU, or Charged/Allowed are present in the Audit Guideline and there is a fee schedule associated with the payer, the appropriate values will be assigned based on the claim type. Audit Manager will assign the non-facility values of wRVU, tRVU, and Charge/Allowed to professional and dental claims. It will assign the facility values of wRVU, tRVU, and Charge/Allowed to facility claims.
October 26, 2025
Audit Worksheet – Action Buttons Added to Top of Page
To improve usability and minimize unnecessary scrolling, the Save & Submit and Run Edits buttons are now accessible at both the top and bottom of the Audit Worksheet. This enables auditors to perform key actions more quickly, regardless of their position on the page. The Run Edits feature is intended to alert auditors to potential issues that may be flagged by payers. These messages serve as warnings, not definitive instructions.
- They assist auditors in identifying areas that might need further review or clarification.
- Messages should be seen as guidance, not as final error determinations.
- Auditors should use their professional judgment to evaluate the relevance and accuracy of each alert within the specific encounter context.
October 11, 2025
Audit Worksheet Enhancements – Reported Column Editing
- The Audit Worksheet now supports independent editing of the Reported column for each auditee. When new auditees are added, the existing reported values are automatically copied to their rows to maintain consistency. From that point forward, auditors can modify the reported value for each auditee individually, without impacting others. This enhancement provides greater flexibility and improves accuracy in audit documentation. All changes are logged in the audit history to ensure transparency and accountability.
September 13, 2025
Creating Projects & Assign Audits
- The process of creating projects and assigning audits has been revamped to be more intuitive, logical and easier to use. Users can now select multiple auditees (providers or coders) and practices at once, significantly improving efficiency.
Audit Worksheet Updates & Improvements
- Comment Field Interaction: The comment fields in the Results section have been redesigned to enhance usability and streamline editing. The text box has been enlarged for better visibility and ease of use, and sensitivity to mouse movements has been removed to prevent accidental disruptions while typing.
- Population of HCC Codes: We’ve enhanced the population of HCC codes within the Audit Worksheet to improve accuracy and workflow efficiency. Upon opening the worksheet, HCC codes are automatically populated for all diagnosis codes. When a diagnosis is added to the audited column or a missing diagnosis code is entered, the corresponding HCC will display immediately after the user tabs out of the field. Audit Manager+ assigns HCCs based on the version specified in the Audit Guideline, and if no HCC is associated with a diagnosis code, “N/A” will be displayed to clearly indicate its absence. Additionally, an error that previously caused scoring when “N/A” was assigned has been corrected for both closed audits and audits in process.
- Errors on Missing Codes: Metrics are now correctly applied to the Audited column for Line Procedure Codes when new service lines are added. After entering a procedure code (e.g., 99213 or 99221) in the audited field and tabbing out, the system will automatically apply the appropriate metrics. This enables the Error tab in the Results section to populate the error picklist, allowing you to assign the correct error. The checklist remains available for optional use.
- Audit Results Table Display Fixed: We’ve corrected display issues in the Audit Results table, where possible points and deductions were not showing accurately. Values now reflect correctly, ensuring clearer scoring and error assignment.
August 25, 2025
Auditee-Specific Reported Values
- The Audit Worksheet now supports entry of unique reported values for each auditee. For example, users can input one reported value for the provider, a different value for the coder, and still record the correct code associated with each auditee.
Streamlined HCC Description Assignment
- The assignment of HCC codes and descriptions within the Audit Worksheet is now determined by the HCC version selected in the Audit Guidelines or Project settings. This replaces the previous reliance on encounter or claim data, eliminating the need for additional information.
RVU and Financial Data Enhancements
- The Audit Worksheet now allows users to enter RVU and/or Charged/Allowed financial values. If you prefer to use CMS’s National Fee Schedule, there is no longer a need to manually load payer-specific fee schedules—the national schedule will automatically populate the RVU and Charged/Allowed fields.
- RVU and financial values are now assigned based on the payer and the date of service (DOS), regardless of whether the data element is marked for “Review” or “Display.” This enhancement supports financial impact calculations using either RVU-based or dollar-based fee schedules tied to the DOS of the encounter.
- Audit Manager+ determines the appropriate payer by first checking for a fee schedule linked to the Audited Payer. If none is found, it defaults to the Reported Payer. If no payer-specific fee schedule exists, the system will automatically apply values from the CMS National Fee Schedule.
Encounter Status Change Tracking
- To support expanded KPI reporting, Audit Manager+ now tracks the date and time when an encounter’s status or sub-status is updated. This enhancement enables future reporting and provides users with a clear audit trail of actions taken.
- Users can view this transaction history by clicking the three-dot menu in the upper right corner of the Audit Worksheet. Each entry includes:
- Changed By: Name of the individual who made the update
- Old Status: Previous status or sub-status of the encounter
- New Status: Updated status or sub-status
- Timestamp: Date and time the change occurred
- This feature ensures full visibility into encounter activity and supports compliance and operational transparency.
Bulk Import Enhancement: ICD-10-CM (Prof/Den)
- Audit Manager+ now supports bulk importing up to 65 diagnosis codes per encounter for ICD-10-CM (Professional/Dental). This expansion allows users to audit all diagnosis codes associated with an encounter, ensuring comprehensive review and reporting.
- Diagnosis codes are optional—you may import as few or as many as needed for your audit workflow.
- This flexibility supports both targeted audits and full-code reviews, depending on your operational needs.
- This update empowers teams to align import behavior with encounter complexity and audit scope.
Auditor Expanded Role in Multi-Account
- The Auditor Expanded role, which was previously limited to the Enterprise version, is now available in the multi-account version of Audit Manager+. This role allows auditors to create projects and manage Dates of Service (DOS) while maintaining strict boundaries that prevent administrative access or visibility into other users’ data.
Audit Guideline Cloning
- Users can now clone Audit Guidelines to create new ones without manual input quickly. Cloning duplicates all attributes, configurations, and rules into a new Draft version, which can be edited before activation. This feature is available in both Enterprise and Multi-Account versions of AM+.
Metrics Uniqueness by Type, Data Element, and Code
- Metrics are now required to be unique by the combination of Metric Type, Data Element, and Procedure Code. You can create multiple metrics with the same Data Element and Procedure Code if each has a different Metric Type. If all three fields match, the system will display a validation message and highlight the conflicts until resolved.
August 4, 2025 Hotfix
Auditor Expanded Role in Multi-Account
- The Auditor Expanded role, previously limited to the Enterprise version, is now available in the multi-account version of Audit Manager+. This role grants auditors the ability to create projects and manage Dates of Service (DOS) while maintaining strict boundaries that prevent administrative access or visibility into other users’ data.
July 2025
Manage Audit Settings: Metrics – Support for Procedure Code Ranges
- Users can now enter ranges of procedure code (e.g., 80000–89999,99000,99910) in addition to single codes when adding or editing metrics. This enhancement makes it easier to define metrics that apply to broad sets of codes. The entered range is retained upon saving and fully supported in AM+.
Manage Audit Settings: Save & Next Button for Checklists and Metrics
- A new Save & Next button has been added to the Add and Edit screens for both Checklists and Metrics in Manage Audit Settings. This allows users to save the current item and immediately move to the next, making it faster to set up or review multiple entries. The button respects existing sort and filter settings, is hidden in Copy mode, and prevents navigation if saving fails.
Audit Worksheet: Auto-Populate Fields for New Service Lines
- When adding a new service line group in the Audit Worksheet, the system now auto-populates key fields to improve efficiency. If the first service line contains a Date of Service (DOS) and Place of Service (POS), those values are copied into each new service line group. Fee Schedule and RVU amounts are also automatically filled based on the assigned Fee Schedule. Line Procedure Code and few other fields remain blank for manual entry.
Data Elements: Principal ICD-10-CM Field Now Supports HCC Values
- You can now add HCC values to the Principal ICD-10-CM field, enabling more complete and accurate risk-adjusted coding analysis.
June 2025
Audit Guideline Enhancements
- User can now easily clone, edit, or inactivate audit guidelines. Inactivating a guideline ensures it won’t be used in new projects, but it will still be available for any ongoing projects. This provides more flexibility and control over how guidelines are managed. Also, only the Active guidelines will be listed when creating new projects or assigning audits.
Audit Worksheet - Master Comments Enhancements
- Users can now search each column such as Category, Sub-Category, Short Description, and Long Description independently to quickly locate relevant comments. Additionally, users can mark their frequently used favorites in the Master Comments table for easier access and reuse.
Metrics Deductions Category Enhancements
- A new HCC option is now available in the Deductions Category to support tracking and scoring of HCC related deductions.
Audit Worksheet – Searches Within Checklists and Errors Enhanced
- Users can now use a search field at the top of the Checklist and Error picklists in the Audit Worksheet Result section to quickly find specific items across Header, Line, Chart, and Audit areas. This makes finding checklists and error messages more efficient. The selected options in the search field no longer appear by default but will be highlighted in bold when the field is focused, maintaining clarity while keeping past selections easily accessible.
Checklists Enhancements
- The Checklist Run Report now includes two new columns: Element Type, which shows the type of each checklist item, and Supporting Text, which displays the defined text for the related audit element. This provides clearer detail in the report.
Metrics Page Enhancements
- A problem with inactive metrics not being visible has been resolved. Users can now toggle between active and inactive metrics on the Metric List page using the Status search field.
Support for CMS Prolonged Service Codes
- Audit Manager+ now supports CMS prolonged codes with E/M codes for improved accuracy and compliance. This including Office & Outpatient (99205, 99215), Home/Residence (99306, 99310), Hospital Inpatient & Observation (99223, 99233, 99236), and Nursing Facility (99306, 99310).
Audit Worksheet – Auto Populate MDM Level in Dependent Checklists
- When an E/M MDM checklist includes a calculated MDM level (e.g., Moderate), that value is now automatically selected in the MDM picklist of any secondary checklist that requires it, if no manual value has been set. The system pulls from the overall rating field and updates dependent checklists accordingly. If the original MDM value changes, linked checklists update as well. All the auto-population actions are logged for traceability.
May 26th, 2025
Personalize the Columns Displayed
Users can now customize which columns are displayed on many of the most frequently used list pages, especially those with numerous columns. These display preferences are saved automatically and will persist across sessions. To customize the columns, click on the Action menu and select Show/Hide Columns, then choose the columns you wish to display or hide. This feature is available on the following pages: View by Audits, View by Projects, Audit Work Queue, and QA Work Queue.
Audit Work Queue – Reorganized Filters
- The search filters in the Audit Work Queue have been reorganized to enhance usability. The Status and Sub-Status filters are now permanently visible on the main page, making them quicker and easier to access due to their frequent use.
Records - Uploaded Documents Enhancements
- The Uploaded Documents feature under the Records section—formerly known as Upload History—has been enhanced with improved search capabilities and added filter options. These upgrades allow users to quickly locate and manage uploaded files by applying filters such as date range, file type, and more, resulting in a more efficient and streamlined document management experience.
Enhance Metric With “Not Score” Option
- The Metric Add & Edit functionality has been enhanced with a new “Not Score” option. When selected, it automatically sets the possible points and deduction points to zero, allowing users to exclude specific metrics from scoring.
Identify & Assign Claims – Usability Enhancements
- The Identify & Assign Claims interface in Claims Connect has been updated to enhance usability. The font size has been reduced to maximize content visibility, and users can now click anywhere on a row to select it for audit—stream lining the selection process.
May 5th, 2025
- Checklist Scoring Update: Resolved an issue that caused incorrect calculation of checklist scores.
- Metric Update: Corrected a bug that allowed metric score values to include more than one decimal place. Scores are now limited to a single digit after the decimal point.
- Bulk Import Enhancement: The Bulk Import file now follows the same auditee identification logic as Audit Manager Professional. Users may enter either the Auditee ID or Auditee Name, based on availability. If both are unavailable, provide whichever value you have. We strongly recommend using the Auditee ID for the most accurate identification, as it helps prevent errors related to duplicate names, misspellings, middle initials, and similar discrepancies.
- View by Audits – Missing Sub-status Filter: Reinstated the missing sub-status filter in the View by Audits page. This enhancement restores full filtering capability, allowing users to track audits more precisely by sub-status.
- Audit Guidelines & Checklists by Product Version: To eliminate confusion between the two versions of Audit Manager, the guidelines and checklists have been separated. Users will now see only the resources relevant to the specific version they are using.
April 2025
Enterprise Versions of Audit Manager Professional and Audit Manager+
- Create Project Title: To more accurately represent the menu's functionality, the Manage Projects sub-menu has been renamed to Create Projects.
- Audit Management Title: The title of the sub-menu Audit Work Queue has been revised to Audit Management to ensure clear differentiation from the My Work Queue menu title.
Audit Manager+
- Displaying HCC Code: When HCC auditing is enabled, and a diagnosis code lacks a corresponding HCC code, a value of "N/A" will be displayed to indicate there is no code.
- RVU Added For Financial Calculations: A data element for RVU has been incorporated. This field will be populated with the work RVU derived from the fee schedule assigned to the payer for the encounter.
- Charged/Allowed Added For Financial Calculations: A data element for "Charged/Allowed" has been introduced. If an amount is present in the "Charged" field during bulk import, it will be imported into this field. Otherwise, the "Allowed" amount will be populated from the fee schedule assigned to the payer for the encounter.
- Audit Summary Table In Audit Worksheet: A new table has been added to the Audit Result section at the bottom of the Audit Worksheet, providing a continuous summary of each auditee's score. The "Possible Points" and "Deductions" columns reflect the current point values for all completed encounters for the auditee.
March 2025
Audit Manager Lists
- The Auditee Listing page is now optimized for better performance, with improved filters, text searches, and sorting. Users can select the number of rows to display in the list portion of the page, ranging from 25 to 200, enhancing efficiency and user experience.
Audit Guidelines
- The Data Elements tab has been enhanced so that users can determine which auditees (provider, coder, or generic) the data element applies to. Users must select at least one auditee for each data element but can select all three auditees.
Metrics
- Metrics have been enhanced to allow users to customize the possible points for each data element.
If the Score Type is set to "Not Scored," users need to set the Possible Points to zero. In addition, all errors need to be set to zero.
Checklists
- The checklists have been enhanced to allow users to define the possible points and deductions for scorable items within checklists.
- Possible points and deductions can only be assigned to Element Types of Yes/No/NA.
- Audit Manager+ has a standard set of checklists. Many of them relate to the Suggested Code logic. The Audit Elements that relate to the Suggested Code logic cannot be modified, except for the supporting text. These required checklists and audit elements are identified by a “+” at the end of their names.
Manage Projects
- There are two types of Audit Guidelines: 1) the default Audit Guideline and 2) the Project Guideline. A default Audit Guideline is assigned when the project is set up. Once the default Audit Guideline is attached to the project, a copy is made, and the guideline can then be customized for the specific needs of the project. Once it is assigned to a project and customized, it is known as the Project Guideline. It is important to understand the difference and customize the guideline(s) accordingly. To aid understanding, we have enhanced the titles to be more specific.
- The Manage Project page now displays the name of the default Audit Guideline in a new column, with the same name, next to the project name.
- To view the Project Guideline, click on the project name link. To edit the Project Guideline, click on the pencil at the end of the row.
Audit Worksheet
- The page previously referred to as the Audit Box has been renamed to Audit Worksheet to better reflect its function within the audit process.
Audit Worksheet - Optimized Layout & Enhanced Navigation
- The Audit Worksheet has been enhanced to reduce scrolling and minimize white space, resulting in a cleaner, more compact interface that enables auditors to view more audit details simultaneously.
- Additionally, the Result Box now features separate tabs for Errors, Checklists, and Master Comments, streamlining navigation and organization for a smoother workflow.
- If a checklist is assigned to a data element, the checklist tab will be displayed when the user opens the results section.
- If no checklists are associated with the data element, the Errors tab will be automatically presented.
Audit Worksheet - Numbering of Multiple ICD-10-CM (Prof/Dental), ICD-10-CM and ICD-10-PCS Codes
- For professional encounters, assigning numbers makes it easier to link a diagnosis code to a procedure code.
Audit Worksheet - Flexible Checklist Management in Results Section
- Checklists in the Results section are now independent for each auditee. Users can delete checklists if they do not apply to a particular auditee.
- An auditor can delete a checklist automatically assigned by the system, and it will not be restored. After deleting a checklist, if the auditor determines they need it, it can be selected from the picklist of checklists at the top of the tab.
Audit Worksheet - Enhanced Chart & Audit Sections
- The Chart and Audit sections have been changed from tabs to sequentially follow each other. The Chart section follows the Service Line section, and the Audit section follows the Chart section.
- The Results section has been rearranged into tabs as described above for the data elements.
- The Audit section does not need to be completed for each encounter. However, it is available if needed, allowing the auditor to add comments before all encounters have been completed.
Audit Worksheet - Audit Data Element and Auditee
- The Audit Worksheet now supports independent scoring for each auditee for each data element assigned to them.
- To set this up, select the Data Elements you want to assign to each auditee.
- Auditors click on the appropriate auditee tab to complete checklists, assign errors, and record audit findings.
- Only the audit findings on the auditee’s tab will be included in that auditee’s report.
Audit Worksheet - Auditors Can Custom Scoring
- Users can now customize the possible points within the Results section of the Audit Worksheet.
- The possible points and deductions from both the Metrics and Checklists can be overridden by auditors.
- Auditors can change the Scoring Category for individual results from errors and checklists.
Charged/Allowed Amount Data Element
- A new data element has been added to improve tracking and analysis, ensuring better visibility into charged and allowed amounts within audits.
Audit Work Queue
- Users can now delete DOS entries from the Audit Work Queue, providing better control over audit data management and improving workflow efficiency.
January 2025
Audit Guidelines
- The Data to Audit section now allows the use of audit guidelines for the type of claim purchased.
- Support Auditing of Professional, Facility and Dental claims. Audit Manager+ has been enhanced to allow clients to select the types of audits they need to perform. This personalized solution brings cost efficiency and flexibility. Clients can purchase and activated each type of claim.
Client Settings
- Claim Type Options: New settings added under Audit Manager+ allow clients to enable different claim types, enhancing customization and flexibility.
Payer Management & Fee Schedules
- Redesigned Listing Table: The Payers listing table under Admin
Manage Lists has been redesigned to enhance readability, functionality and streamline navigation.
- Link One Fee Schedule to All Payers: To improve efficiency Audit Manager has been enhanced so you can link all payers to one fee schedule at the same time. This can be either the national CMS fee schedule or a custom fee schedule.
- Delete Fee Schedule Linked to All Payers: Users can now delete a fee schedule linked to all or specific payers. Simply select the desired payers and click the Delete Fee Schedule option to remove the link.
Audit Box
- Run Edit: The Run Edits feature in Audit Manager+ validates codes against patient data and services on the same DOS. Warnings are displayed for potential errors, which auditors can review without needing to resolve them to complete the audit. The button is located at the bottom of the Audit Box for easy access.
- Internal Encounter Notes: Audit Manager+ now allows users to add internal notes for individual encounters or claims within the Audit Box. These notes, used for recording audit-related information, questions, or QA issues, are internal-only and excluded from reports.
- HCC Integration: HCC functionality from Audit Manager Professional is now in Audit Manager+. Activated HCC auditing assigns an HCC code to each diagnosis, displaying the version alongside the code (e.g., E50.9 to HCC-331, V28-331). For projects with multiple HCC versions, codes are separated by commas (e.g., V24-51, V28-51).
- Automated MDM Levelling: MDM options are now in a checklist with sections for Problems, Data, and Risks. Audit Manager calculates the MDM level based on selections and entries, displaying section levels and the overall level in the Line Results and detailed reports.
- Suggested Codes: Audit Manager+ now includes suggested code logic. Checklists, assigned based on the reported code, collect data like visit type to determine suggested codes. For many E/M codes, two checklists are required: one for MDM level and another for additional details. Based on responses, the suggested code is displayed in the Line Results section.
- QA Alerts Integration: QA Alerts in Audit Manager+ flag situations requiring a QA Reviewer or second auditor's attention, enhancing audit accuracy. Enable alerts in User Settings and configure them for specific business scenarios.
2025© Healthicity, LLC
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