100% das contas auditadas, jornada do paciente e leitos acompanhados em tempo real. Sua equipe decide os casos de impacto, e o resultado é medido em reais, conta por conta.
Em produção na saúde brasileira
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100% das contas auditadas com 450+ modelos clínicos, e o auditor decidindo só os casos de impacto.
VerTempo de permanência, diárias excedentes, giro de leitos e alta hospitalar acompanhados em tempo real.
VerA jornada do paciente ao vivo e o alerta antes do estouro de SLA, não no relatório do dia seguinte.
Ver92% das contas são liberadas automaticamente e o auditor fica com os casos que mudam o resultado. A capacidade cresce sem a equipe crescer.
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Sinistralidade, auditoria de contas e glosa, escritos de dentro da operadora.
Sinistralidade é a parte da mensalidade que a operadora gasta com assistência. Em 2025 o setor fechou em 81,7% (ANS). Veja a fórmula, a decomposição do índice em frequência, preço, mix e erro de conta, e as 6 alavancas que uma operadora controla de fato, com exemplo numérico.
Guia da auditoria de contas médicas pela ótica da operadora: etapas do TISS ao recurso de glosa, o que o auditor procura, amostragem versus cobertura total, indicadores e o papel da IA.
O que é glosa hospitalar, os tipos e os códigos TISS de motivo, como a operadora analisa e fundamenta cada item, glosa justa e indevida com o custo do erro para os dois lados, prazos de recurso pela ANS e como a auditoria consistente reduz glosa indevida.
