Example denied-claim recommendation card
Revenue Recovery

Every denied claim,
returned with a fix.

Revenue Recovery reviews every denied, rejected, and underpaid claim, then hands your team a cited, ready-to-resubmit recommendation. Your team reviews answers, not analysis.

What it does

Your specialists, multiplied.

Our AI agents do the reading, cross-referencing, and root-cause analysis your best biller does by hand across every claim in the queue, not just the largest few. Your team gets a clear, cited recommendation for each denial in one place.

01

Every claim, reviewed

The whole denial queue gets worked, so claims stop aging out untouched.

02

A cited fix for each

The exact correction, down to the service line, with the sources behind it.

03

Underpayments surfaced

Claims paid below your contracted rate are flagged automatically.

04

Faster resubmission

Your team reviews the answer and resubmits, not each case from scratch.

How it works

From denial to resubmission, in three steps.

The investigation happens before a person ever opens the claim. Your team comes in at the end to review and resubmit.

Step 01

Connect

Securely sync your claims, remits, contracts, and charts. No workflow change.

Step 02

Investigate

The agent reviews every denial against payer policies, LCD/NCD, and coding rules.

Step 03

Recommend Fix

It returns the fix at the service-line level, with every source cited.

Step 04

Hand off

Your team reviews, applies the fix, and resubmits. The claim gets paid.

Under the hood

Four agents, one investigation.

A denial is rarely fixed by reading one document. Each agent reads one part of the case the way a specialist would, then they reconcile what they find into a single, cited fix.

Clinical Agent

Analysis complete

Summary

Clinical documentation supports a specific symptomatic arrhythmia rather than the unspecified code that was originally billed. The charted episodes strengthen the appeal and justify a more specific diagnosis.

Details

Recommended ICD-10
I47.1 I49.81
Documentation Status
Sufficient
Medical Necessity
Supported by episodes

Recommended arguments

+ For
  • Encounter note references recurrent palpitations with documented dizziness.
  • Prior ECG corroborates the rhythm concern and supports escalation.
  • Ordering provider assessment ties the symptom pattern to the billed service.
× Against
  • The narrative is weaker if the encounter note is not attached to the resubmission packet.
  • No prior monitoring attempt is documented to establish failed conservative follow-up.

Evidence

Progress note
07/12/2024

Intermittent palpitations and transient dizziness over six weeks; denies syncope. Plan: ambulatory rhythm monitoring.

Inside the product

See where the work happens.

Two connected workspaces your team lives in. Claim Flow is where denials get resolved. True Pay is the library that makes every fix accurate.

Claim Flow workspace showing a service line review, recommended actions, and agent findings.
Claim Flow

Every claim and denial, in one workspace.

Claim Flow gives you a single list of encounters, claims, and service lines, with views that switch to match how your team works. Open any claim for its recommended actions, or drill into a service line for the full agent analysis.

  • Claims, encounters, and service line views
  • Recommended actions on every claim
  • Service-line agent analysis, with cited findings
True Pay

The source of truth behind every fix.

True Pay is the library every recommendation is built on: your contracts, payer policies, fee schedules, standard charges, and modifiers, kept current in one place. It is what lets each agent cite an accurate, defensible fix.

Contracts All Standard Charges Payers Tag Label Tag Label
True Pay workspace showing contracts, payers, and fee schedule data.
What you recover

Three kinds of revenue you get back.

Denied & rejected claims

Investigated and corrected at the service-line level, with cited fixes your team can trust.

Underpaid claims

Payments below your contracted rate, flagged automatically. Revenue you would have missed.

The next denial

Root-cause patterns surfaced so your team can fix them upstream and stop the repeat.

See what you can recover.

Edit any number below to see the recovery update live. We build the real model with you in the pilot.

$14.5M
Estimated Annual Recovery

Illustrative estimate based on the figures you enter. Actual recovery depends on your payer mix, contracts, and denial patterns.

Denials resolved. Revenue restored.

Every day a denial sits unworked is a day you wait on money your team has already earned. Revenue Recovery turns that wait into a fix.

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