Healthicity
Starts at $500/month
Regulatory Status Disclosed
Overview
Healthicity offers AI-powered tools designed to assist healthcare organizations with compliance management and auditing. Its primary offerings include Compliance Manager and Audit Manager+.
- What it does: Healthicity’s platforms aim to streamline compliance programs and auditing processes. Compliance Manager helps manage various aspects of compliance, including incident tracking, risk assessments, policy management, and employee training. Audit Manager+ focuses on automating coding, compliance, and audit workflows, offering features like customizable audit templates, real-time reporting, and risk adjustment tools.
- Who it is for: These tools are intended for a range of healthcare organizations, including hospitals, health systems, physician groups, and long-term care facilities. The AI capabilities are particularly relevant for medical coders, CDI specialists, and auditors.
- How it fits a clinical or practice workflow: Healthicity integrates into practice workflows by providing a centralized, web-based system for managing compliance and auditing tasks. For example, Compliance Manager allows for tracking and resolving incidents from initial report to resolution, and Audit Manager+ can suggest medical codes and check the accuracy of coded data. The SmartLine feature, an AI-powered compliance hotline, allows employees to report concerns, with AI capturing and summarizing reports for the compliance team.
- Notable capabilities: Key features include customizable workspaces and real-time reporting for compliance, as well as advanced customization options and the ability to audit a provider and coder simultaneously within the auditing tool. The AI in Healthicity’s tools can assist with suggesting medical codes (ICD-10 procedure and diagnosis codes) and checking the accuracy of coded data.
Reviewed by Pouyan Golshani, MD — Interventional Radiologist
Key Features
- Customizable workspace and real-time reporting
- Employee training and learning management system (LMS)
- Risk assessment management (including HIPAA Privacy & Security)
- Incident investigation and reporting (including AI-powered SmartLine hotline)
- Total oversight of audit program with advanced customization
- Ability to audit a provider and a coder at the same time (Audit Manager+)
- Automated screening and exclusion monitoring
- Policy and procedure development and management
- Third-party management
- API Integration and Single Sign-on
Use Cases
- Compliance program management
- Healthcare auditing (coding, documentation, provider)
- HIPAA compliance and risk assessments
- Employee training and education
- Incident tracking and resolution
- Exclusion and sanction monitoring
What Physicians Need to Know
HIPAA Compliance Monitoring
Healthicity offers intelligent HIPAA risk assessments with AI-identified gaps, guiding organizations through security risk analysis. The Compliance Manager integrates HIPAA risk assessments and provides services for Privacy Rule and Security Rule risk assessment and corrective action. It also facilitates the creation of HIPAA Workplans to document and track corrective actions, assign tasks, and monitor progress for compliance items.
Contract Analysis
The platform includes Unlimited Contract Management for enterprise clients and a Third-Party Management feature to efficiently manage agreements, identify business associates, and assess risk levels. Healthicity emphasizes tracking and regular review of contract terms to prevent violations and streamline compliance demonstration through automation and centralization.
Regulatory Update Tracking
Healthicity provides Regulatory Alerts and Regulatory Change Management to help organizations stay current with evolving laws and regulations. They offer resources like OIG Work Plan Updates to highlight increasing compliance risks and areas of audit focus, and the customizable workspace in Compliance Manager delivers the latest regulatory updates.
Policy Management
Healthicity Compliance Manager features robust Policy Management, enabling organizations to develop, revise, and centralize policies and procedures. It supports policy lifecycle management, version control, automated review routing, and customized policy creation to guide ethical decision-making and ensure compliance adherence. Policies can be made accessible to all employees and updated regularly.
Incident Reporting
Healthicity offers SmartLine Incident Reporting, an AI-driven compliance hotline for 24/7 anonymous reporting. It provides immediate access to recorded calls and AI-generated transcriptions, sending real-time notifications for swift action. The Compliance Manager includes a comprehensive Incident Management module for documenting, tracking, investigating, and resolving incidents, supporting multi-channel reporting and direct user submissions.
Staff Training Compliance
The platform includes an Education & Training suite with a Healthcare Learning Management System (LMS). This LMS offers a comprehensive library of expert-approved training courses, administrative controls, insightful reporting, and customized portals. It supports role-based training, including for medical coding, billing, and documentation, and helps develop annual training plans that incorporate audit findings and regulatory changes.
Audit Preparation
Healthicity provides Auditing Solutions and Audit Manager+, which automates the tracking and management of internal and external audits. Its AI-powered medical coding audit reviews clinical documentation for accuracy and compliance, reducing OIG audit risk. Audit Manager+ offers customization, real-time insights, and the ability to audit providers and coders simultaneously, centralizing audit results and streamlining reporting.
Documentation Standards
Healthicity's AI capabilities offer documentation improvement suggestions for coders and clinicians to enhance coding accuracy. The platform emphasizes clear, concise, and legible medical record documentation for validating conditions and optimizing the revenue cycle. They provide training on risk adjustment and eliminating documentation gaps, along with resources like checklists for medical decision-making documentation.
Physician Tip
Physicians can leverage Healthicity's Compliance Manager for a streamlined, unified view of compliance tasks, risk assessments, and incident reporting, significantly reducing administrative burden. The AI-powered coding audits and documentation improvement suggestions are invaluable for ensuring accuracy, optimizing revenue, and minimizing audit risks. Engaging with the Learning Management System for role-based training on compliance, coding updates (CPTu00ae, ICD-10, HCPCS), and documentation standards helps physicians stay current. Furthermore, active participation in HIPAA risk assessments and utilizing incident reporting tools like SmartLine enables proactive identification and resolution of potential vulnerabilities, fostering a culture of safety and compliance within their practice.
Healthicity's Compliance Manager offers API Integration, including with HR Systems and Single Sign-on, particularly for Enterprise plans. It is designed to integrate with existing educational resources and aims for seamless integration with current systems for continuous learning and adaptation to changing regulations. SmartLine, the AI-powered compliance hotline, can also integrate with existing systems. While the depth of EHR integration may vary, the platform is built to connect and streamline compliance workflows.
Details
| Category | Legal, Compliance & Security, Medical Billing & RCM |
| Pricing |
Starts at $500/month
|
| Deployment | Cloud |
| Compliance | |
| BAA Available | Unknown AI-estimated |
| HIPAA Compliant | Unknown AI-estimated |
| FDA Status | Not applicable AI-estimated |
| Integrations | |
| EHR | Not specified |
| Specialties | Family Medicine, Internal Medicine, Radiology |
What the Web Says
Healthicity offers compliance and revenue cycle solutions for healthcare organizations, including Compliance Manager and Audit Manager. The Compliance Manager is praised for its user-friendliness, excellent customer support, and comprehensive features for managing compliance tasks, incident tracking, and training. The Audit Manager is also noted for its simplicity and ability to expedite audits.
Overall: PositiveStrengths
- User-friendly and easy to navigate interface.
- Excellent and prompt customer support.
- Comprehensive features for compliance management, incident tracking, and training.
- Streamlines and organizes compliance processes, especially for multi-state operations.
- Effective for managing staffing workforces and sanction screening.
- Simplifies medical documentation and coding reviews, improving auditing efficiency.
Limitations
- Incident reports can be challenging or clunky for employees to use.
- Limited customization options in some areas.
- User interface can be aggravating at times and could use better reporting tools.
- Frequent updates require employee training/education.
- Some users desire the ability to upload their own education documents into the Audit Manager without purchasing another tool.
- Concerns about auto-renewal of subscriptions and lack of flexibility in terms.
Based on reviews from: G2, Capterra, Software Advice, Slashdot, Indeed.com
Last updated: 2026-08-12
Ratings & Reviews
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Press & Coverage
Compliancy Group
Compliancy Group Acquires Healthicity, Creating the Definitive Platform for Healthcare Compliance and Auditing
Compliancy Group has acquired Healthicity, uniting two prominent names in healthcare compliance and auditing to create a comprehensive platform for managing compliance programs. This acquisition aims to provide a single ecosystem for various compliance elements, including auditing, workforce training, risk assessments, and incident management.
2026-06
Healthicity Blog
Healthicity Joins Compliancy Group
Healthicity announced its acquisition by Compliancy Group, highlighting the benefits for customers, including continued support and a path to expanded capabilities within the Compliancy Group platform. The merger aims to deliver a more complete compliance and auditing platform to over 3,000 healthcare organizations.
2026-06
The HIPAA Journal
Compliancy Group Acquires Healthicity - The HIPAA Journal
The HIPAA Journal reported on Compliancy Group's acquisition of Healthicity, noting that the deal expands Compliancy Group's platform to include a wider range of healthcare compliance services. The combined entity will serve over 3,000 healthcare organizations with an integrated approach to compliance and auditing.
2026-06
ADA News
ADA Member Advantage-endorsed Compliancy Group acquires Healthicity
The ADA News covered the acquisition of Healthicity by Compliancy Group, emphasizing that the merger creates a single, expanded platform for healthcare compliance programs. This integration allows healthcare organizations to manage all aspects of compliance, from training to auditing, through one trusted partner.
2026-07
Healthicity Blog
Practical Skills for More Effective Audits
This article from Healthicity's blog discusses the evolving role of auditors in healthcare, emphasizing the need for skills beyond technical expertise to identify risk, validate compliance, and strengthen operational integrity. It highlights the importance of auditors providing independent insight and supporting accountability.
2026-06
Healthicity Blog
Compliance KPIs Healthcare Organizations Should Be Tracking Right Now
Healthicity's blog post addresses the challenge healthcare organizations face in measuring compliance effectiveness, with over 50% identifying policies and procedures as a major hurdle. The article provides a practical checklist for compliance KPIs to help organizations track and improve their compliance programs.
2026-06
Healthicity Blog
How AI Is Transforming Healthcare Revenue Cycle Operations
This Healthicity blog post explores the transformative impact of Artificial Intelligence on healthcare revenue cycle operations. It discusses how AI is becoming increasingly embedded in healthcare systems, from documentation tools to patient-facing chatbots, while also acknowledging the accelerating regulatory scrutiny.
2026-06
Healthicity Blog
Breaking Down the Latest OIG Work Plan Updates for April 2026
Healthicity's blog provides an analysis of the April 2026 OIG Work Plan updates, highlighting new areas of oversight such as rising lab costs, compounded GLP-1 risks, and increased scrutiny on Medicaid and NIH oversight. This information is crucial for compliance leaders to assess potential impacts on their organizations.
2026-05
Videos
Product demos, reviews, and walkthroughs for Healthicity.
Healthcare is Complicatedu2014Your Compliance Program Deserves Simplicity
Healthicity
The Intersection of Healthcare Compliance and Cybersecurity - Webinar
Healthicity
Compliance, Simplified - Healthcare Compliance Webinar
Healthicity
4 Incident Management Tricks That Will Make You More Productive - Healthcare Compliance Webinar
Healthicity
Failure to Comply u2014 Examples of Business Associates Gone Wrong (Healthcare Compliance Webinar)
Healthicity
Frequently Asked Questions
Healthicity incorporates AI into solutions like SmartLine, an AI-powered compliance hotline, to streamline reporting and efficiency. They also provide resources and insights on how AI can enhance risk assessment, automate monitoring, and offer data-driven insights to detect potential fraud, waste, or abuse within healthcare compliance programs.
Healthicity emphasizes the importance of establishing clear compliance guardrails and proactive strategies when leveraging AI in healthcare, particularly concerning HIPAA and other regulations governing patient outreach. Their platform, Compliance Manager, is designed to be HIPAA compliant and integrates features like risk assessments and incident management to help organizations adhere to regulatory standards.
While AI can enhance efficiency and identify patterns, physicians express concerns about potential unreliability if AI focuses solely on profit or uses skewed data, highlighting the need for human oversight. Healthicity's discussions on AI in healthcare emphasize that AI should assist human healthcare professionals collaboratively, with the final decision resting with a human.
Yes, several alternatives offer healthcare compliance and risk management solutions. Competitors and alternatives to Healthicity's offerings include MedTrainer, RLDatix, Compliancy Group, and iMedX, many of which also incorporate AI for various functions like coding and risk management.
Healthicity's Compliance Manager offers tiered pricing plans, such as Foundation starting at $500/month and Professional at $1450/month, with custom quotes available for enterprise solutions. Pricing can vary based on the number of employees and the specific features required, with discounts often available for annual billing.
Healthicity's Compliance Manager is a HIPAA-compliant platform that includes features like data security and risk analysis to protect sensitive information. They also provide resources and webinars on managing cyber risk, HIPAA, and governance in healthcare to ensure safeguards and risk controls are in place when using AI.
While Healthicity's AI tools can streamline compliance tasks and provide insights, they are designed to assist rather than replace human oversight. Physicians' involvement remains crucial for ethical considerations, ensuring data accuracy, and making final decisions, as AI functions best collaboratively with healthcare professionals.
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| Last Verified: 2026-05-12 | First Added: 2026-05-12