AI in the Healthcare Audits Market Size, Share & Trends Analysis Report By Audit Type (Pre-Billing Audits, Recovery Audits, Medicare, External Audits), By Region, And by Segment Forecasts, 2023-2031

Report ID : 2062 | Published : 2023-09-25 | Pages: 180 | Format: PDF/EXCEL

AI in the Healthcare Audits Market Size is predicted to show a 9.8% CAGR during the forecast period for 2023-2031.

AI in Healthcare Audits Market

AI is transforming healthcare audits by automating claims analysis, coding compliance checks, and fraud detection. It improves accuracy, reduces errors, and helps healthcare organizations maintain compliance with regulations like HIPAA. AI also enhances revenue cycle management and identifies potential audit risks using predictive analytics, streamlining the auditing process and ultimately improving patient care and financial outcomes. 

By conducting a clinical audit, healthcare professionals and patients can determine whether or not their services are up to par with industry standards. The advent of new digital tools drives market expansion, and the increasing need for better healthcare services brought on by the gap between patients and healthcare personnel is expected to fuel the growth of artificial intelligence (AI) in the healthcare industry in the coming years. 

The development of AI in Healthcare has been bolstered by the expanding size and complexity of healthcare datasets, as well as by the increasing emphasis on controlling healthcare expenditures. Medical practitioners will benefit more from data-driven care planning and decision-making when AI is included in healthcare operations. The advancement of healthcare technology has led to an anticipated uptick in the use of AI in healthcare audits. 

However, companies need employees with certain skill sets to design, manage, and implement AI systems due to the complexity of these endeavours, which is hindering AI in healthcare audits market growth. In addition, the COVID-19 pandemic has had a major effect on the market for providers of artificial intelligence in AI in healthcare audits. Several factors have contributed to this effect. Artificial intelligence (AI) proved its worth during the recent COVID-19 pandemic by helping medical Professionals better respond to emergencies and get a deeper understanding of difficult diseases. 

Competitive Landscape

Some Major Key Players In The AI in the Healthcare Audits Market:

  • Surescripts
  • Trium Info
  • Aperio AI
  • Protenus, Inc.
  • Medicodio
  • Experian Health
  • Apixio
  • Inovaare
  • Codoxo
  • Semantic Health
  • RevKeep
  • Others

Market Segmentation:

The AI in healthcare audits market is segmented based on the audit type. Based on the audit type, the market is segmented into pre-billing audits, recovery audits, Medicare, and external audits. 

Based On The Audit Type, The Pre-Billing Audits AI In Healthcare Audits Segment Is Accounted As A Major Contributor To The AI In Healthcare Audits Market. 

The pre-billing audits AI in the healthcare audits category is expected to record a major global market share in 2022 because pre-bill audits help find potential sources of reimbursement from the past and the future. Because of this, hospitals can save both time and money. Pre-bill is a method of risk mitigation that is implemented ahead of the usual auditing procedures. This will guarantee honest accounting all around and precise reimbursements. It's also a cost-saver.

The Recovery Audits Segment Witnessed Growth At A Rapid Rate

The recovery audits segment is projected to grow rapidly in the global AI healthcare audits market. Performing a recovery audit might have a significant financial impact. Recovery audits' primary value is that they boost cash flow and pure profits by identifying sources of revenue loss, especially in countries like the US, Germany, the UK, China, and India.

In The Region, The North American AI In Healthcare Audits Market Holds A Significant Revenue Share.

The North American AI in healthcare audits market activity is anticipated to record the largest market share in revenue in the near future. It can be attributed to the expansion of financial resources, and a number of new competitors are entering the AI Healthcare sector in the region thanks to the rise in venture capital funding. Governments, institutions, and investors are increasing funding for projects that attempt to integrate artificial intelligence into the practice of healthcare audit in medicine in response to the rising need for cutting-edge healthcare auditing solutions.

In addition, Asia Pacific is estimated to grow rapidly in the global AI in healthcare audits market because of increasing healthcare facilities, rising fraud activities and the ongoing development of cutting-edge AI technology. The need for AI in healthcare audits is anticipated to grow as a result of this region.

AI in the Healthcare Audits Market Report Scope

Report Attribute


Growth Rate CAGR

CAGR of 9.8% from 2023 to 2031

Quantitative Units

Representation of revenue in US$ Bn and CAGR from 2023 to 2031

Historic Year

2019 to 2022

Forecast Year


Report Coverage

The forecast of revenue, the position of the company, the competitive market structure, growth prospects, and trends

Segments Covered

By Audit Type

Regional Scope

North America; Europe; Asia Pacific; Latin America; Middle East & Africa

Country Scope

U.S.; Canada; U.K.; Germany; China; India; Japan; Brazil; Mexico ;The UK; France; Italy; Spain; China; Japan; India; South Korea; South East Asia; South Korea; South East Asia

Competitive Landscape

Semantic Health, Revkeep, Apixio

Customization Scope

Free customization report with the procurement of the report, Modifications to the regional and segment scope. Particular Geographic competitive landscape.

Pricing And Available Payment Methods

Explore pricing alternatives that are customized to your particular study requirements.

Chapter 1. Methodology and Scope

1.1. Research Methodology

1.2. Research Scope & Assumptions

Chapter 2. Executive Summary

Chapter 3. Global AI in Healthcare Audits Market Snapshot

Chapter 4. Global AI in Healthcare Audits Market Variables, Trends & Scope

4.1. Market Segmentation & Scope

4.2. Drivers

4.3. Challenges

4.4. Trends

4.5. Investment and Funding Analysis

4.6. Industry Analysis – Porter’s Five Forces Analysis

4.7. COVID-19 Impact Analysis

Chapter 5. Market Segmentation 1: By Audit Type Estimates & Trend Analysis

5.1. By Audit Type & Market Share, 2019-2031

5.2. Market Size (Value US$ Mn) & Forecasts and Trend Analyses, 2022 to 2031 for the following By Audit Type:

5.2.1. Pre-Billing Audits

5.2.2. Recovery Audits

5.2.3. Medicare

5.2.4. External Audits

Chapter 6. AI in Healthcare Audits Market Segmentation 2: Regional Estimates & Trend Analysis

6.1. North America

6.1.1. North America AI in Healthcare Audits Market revenue (US$ Million) estimates and forecasts By Audit Type, 2023-2031

6.1.2. North America AI in Healthcare Audits Market revenue (US$ Million) estimates and forecasts by country, 2023-2031 U.S. Canada

6.2. Europe

6.2.1. Europe AI in Healthcare Audits Market revenue (US$ Million) By Audit Type, 2023-2031

6.2.2. Europe AI in Healthcare Audits Market revenue (US$ Million) By country, 2023-2031 Germany Poland France Italy Spain UK Rest of Europe

6.3. Asia Pacific

6.3.1. Asia Pacific AI in Healthcare Audits Market revenue (US$ Million) By Audit Type, 2023-2031

6.3.2. Asia Pacific AI in Healthcare Audits Market revenue (US$ Million) By country, 2023-2031 China India Japan Australia Rest of Asia Pacific

6.4. Latin America

6.4.1. Latin America AI in Healthcare Audits Market revenue (US$ Million) By Audit Type, 2023-2031

6.4.2. Latin America AI in Healthcare Audits Market revenue (US$ Million) By country, (US$ Million) 2023-2031 Brazil Rest of Latin America

6.5. Middle East & Africa

6.5.1. Middle East & Africa AI in Healthcare Audits Market revenue (US$ Million) By Audit Type, (US$ Million)

6.5.2. Middle East & Africa AI in Healthcare Audits Market revenue (US$ Million) By country, (US$ Million) 2023-2031 South Africa GCC Countries Rest of MEA

Chapter 7. Competitive Landscape

7.1. Major Mergers and Acquisitions/Strategic Alliances

7.2. Company Profiles

7.2.1. Surescripts

7.2.2. Trium Info

7.2.3. Aperio AI

7.2.4. Protenus, Inc.

7.2.5. Medicodio

7.2.6. Experian Health

7.2.7. Apixio

7.2.8. Inovaare

7.2.9. Codoxo

7.2.10. Semantic Health

7.2.11. RevKeep

7.2.12. Others

Segmentation of AI in Healthcare Audits Market-

AI in Healthcare Audits Market By Audit Type -

  • Pre-Billing Audits
  • Recovery Audits
  • Medicare
  • External Audits

AI in Healthcare Audits Market Segment

AI in Healthcare Audits Market By Region-

North America-

  • The US
  • Canada
  • Mexico


  • Germany
  • The UK
  • France
  • Italy
  • Spain
  • Rest of Europe


  • China
  • Japan
  • India
  • South Korea
  • South East Asia
  • Rest of Asia Pacific

Latin America-

  • Brazil
  • Argentina
  • Rest of Latin America

 Middle East & Africa-

  • GCC Countries
  • South Africa
  • Rest of the Middle East and Africa

InsightAce Analytic follows a standard and comprehensive market research methodology focused on offering the most accurate and precise market insights. The methods followed for all our market research studies include three significant steps – primary research, secondary research, and data modeling and analysis - to derive the current market size and forecast it over the forecast period. In this study, these three steps were used iteratively to generate valid data points (minimum deviation), which were cross-validated through multiple approaches mentioned below in the data modeling section.

Through secondary research methods, information on the market under study, its peer, and the parent market was collected. This information was then entered into data models. The resulted data points and insights were then validated by primary participants.

Based on additional insights from these primary participants, more directional efforts were put into doing secondary research and optimize data models. This process was repeated till all data models used in the study produced similar results (with minimum deviation). This way, this iterative process was able to generate the most accurate market numbers and qualitative insights.

Secondary research

The secondary research sources that are typically mentioned to include, but are not limited to:

  • Company websites, financial reports, annual reports, investor presentations, broker reports, and SEC filings.
  • External and internal proprietary databases, regulatory databases, and relevant patent analysis
  • Statistical databases, National government documents, and market reports
  • Press releases, news articles, and webcasts specific to the companies operating in the market

The paid sources for secondary research like Factiva, OneSource, Hoovers, and Statista

Primary Research:

Primary research involves telephonic interviews, e-mail interactions, as well as face-to-face interviews for each market, category, segment, and subsegment across geographies

The contributors who typically take part in such a course include, but are not limited to: 

  • Industry participants: CEOs, CBO, CMO, VPs, marketing/ type managers, corporate strategy managers, and national sales managers, technical personnel, purchasing managers, resellers, and distributors.
  • Outside experts: Valuation experts, Investment bankers, research analysts specializing in specific markets
  • Key opinion leaders (KOLs) specializing in unique areas corresponding to various industry verticals
  • End-users: Vary mainly depending upon the market

Data Modeling and Analysis:

In the iterative process (mentioned above), data models received inputs from primary as well as secondary sources. But analysts working on these models were the key. They used their extensive knowledge and experience about industry and topic to make changes and fine-tuning these models as per the product/service under study.

The standard data models used while studying this market were the top-down and bottom-up approaches and the company shares analysis model. However, other methods were also used along with these – which were specific to the industry and product/service under study.

To know more about the research methodology used for this study, kindly contact us/click here.

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