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Full-Scope Overpayment Management

From initial detection to final resolution, PORA gives you complete oversight of every overpayment case. Gain unmatched visibility and control while ensuring recoveries are accurate, efficient, and fully auditable

Built-In Intelligent Algorithms

Proprietary algorithms and machine learning models automatically analyze claims data, pinpoint anomalies, and prioritize high-value cases. This enables faster detection, stronger recoveries, and smarter audit decisions.

Secure, Seamless Deployment

PORA’s API-based architecture ensures rapid implementation without disrupting your operations. Built with state-of-the-art security standards, it delivers scalable performance and long-term reliability you can trust.

PORA - Advanced Audit Automation

Our flagship solution streamlines provider communications and enables bulk validation processing with built-in algorithms and pricing logic.

Automated Letter Generation & Tracking

PORA streamlines provider communications with built-in letter generation and automated tracking. From notifications to follow-ups, every step is logged and auditable, ensuring compliance and reducing manual effort.

Bulk Validation & Processing

PORA enables auditors to validate and process large volumes of claims at once, applying built-in algorithms and pricing logic in bulk. This capability reduces manual review time, increases efficiency, and ensures consistent, accurate results across every case.

Task Assignment & Oversight

Assign cases to auditors, track progress in real time, and ensure accountability across your audit team. PORA’s task management tools make collaboration seamless and transparent.

What PORA Delivers

  • Billing anomaly detection
  • Case tracking and audit workflows
  • Automated letter generation
  • Configurable dashboards and reports
  • Secure data management
  • Easy integration with existing systems

Complete Payment Integrity Suite

The 360 Health Systems Payment Integrity Suite is a portfolio of specialized applications designed to help healthcare organizations strengthen audit accuracy, optimize workflows, and protect revenue. Each application is built to address a critical dimension of payment integrity from advanced audit automation with PORA, to intelligent pricing and grouping with the DRG Grouper & Pricer, and ongoing Algorithm Research & Development that drives continuous innovation. Together, these tools deliver a comprehensive, technology-first approach to detecting overpayments, accelerating recoveries, and supporting long-term operational resilience.

Algorithm Research and development

A dedicated environment for creating, testing, and refining proprietary algorithms. Paired with powerful data exploration tools, it allows analysts to dig deep into real claims data to uncover insights, validate hypotheses, and design solutions that anticipate emerging claim patterns. This R&D engine ensures continuous innovation and smarter overpayment detection.

DRG Grouper & Pricer

A powerful tool for real-time DRG validation and pricing, helping organizations verify coding accuracy, identify discrepancies, and ensure proper reimbursement based on CMS logic.

Complex Audit

The Complex Audit application is built to manage and streamline advanced audit reviews that go beyond standard claim validation. With tools to analyze medical records, reconcile coding, and evaluate high-value or high-risk cases, Complex Audit empowers auditors to resolve the most challenging scenarios with accuracy and confidence. By centralizing documentation, workflows, and decision tracking, it ensures transparency, consistency, and stronger outcomes in complex overpayment detection and recovery

Vendor Portal

The Vendor Portal provides a secure, streamlined gateway for external audit partners and vendors to collaborate within the Payment Integrity Suite. With controlled access, case assignments, and transparent status tracking, it ensures consistent communication, accountability, and compliance across all third-party engagements. By centralizing interactions, the Vendor Portal simplifies vendor management and supports efficient, large-scale audit operations.

Automated Letter Generation & Tracking

PORA streamlines provider communications with built-in letter generation and automated tracking. From notifications to follow-ups, every step is logged and auditable, ensuring compliance and reducing manual effort.

Bulk Validation & Processing

PORA enables auditors to validate and process large volumes of claims at once, applying built-in algorithms and pricing logic in bulk. This capability reduces manual review time, increases efficiency, and ensures consistent, accurate results across every case.

 

Task Assignment & Oversight

Assign cases to auditors, track progress in real time, and ensure accountability across your audit team. PORA’s task management tools make collaboration seamless and transparent.

 

Task Assignment & Oversight

Assign cases to auditors, track progress in real time, and ensure accountability across your audit team. PORA’s task management tools make collaboration seamless and transparent.

 

Key Benefits

Discover how PORA can transform your payment integrity operations
and deliver exceptional value.

Increased Recovery

Maximize recovery of overpayments with our advanced detection algorithms.

Reduced Waste

Eliminate unnecessary costs by detecting billing errors, duplicate charges, and inefficiencies before they impact payments.

Time Savings

Automate manual processes to free up valuable staff time.

Improved Accuracy

Enhance payment accuracy with our comprehensive review process.

Actionable Insights

We continuously evolve our technology to
stay ahead of industry challenges.

Enhanced Collaboration

Facilitate better communication between departments and stakeholders.

Ready to Transform Your Payment Integrity?

Schedule a demo to see how 360 Health Systems can help you recover lost revenue and reduce financial waste.

Request a Demo
Explore the Platform

Ready to See PORA in Action?

Schedule a Demo to see how our comprehensive payment integrity
solution can help you recover lost revenue and reduce financial waste.

Request a Demo
360 Health Systems equips payers with the intelligence to uncover overpayments, recover lost revenue, and reduce financial waste.

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