of providers report increasing denial rates year over year
of hospitals operate at negative margins
lost annually to preventable denials by the average health system
is spent annually fighting claim denials across the industry
Every denied claim represents revenue you’ve already earned but aren’t collecting. Every manual appeal consumes staff time that could be spent on higher-value work. And every day without modern technology widens the gap between what payers can do and what you can defend against.
Outright denials are visible and trackable. But the revenue erosion that costs health systems the most often goes undetected:
Payers use AI to find opportunities to downgrade DRGs—moving a case from a higher-paying DRG to a lower one based on documentation technicalities. These partial denials often go unworked because the manual effort to challenge each one exceeds the individual recovery amount.
Payers misapply contracted rates, use incorrect fee schedule versions, or fail to honor authorizations. Without systematic post-pay audit, these underpayments become accepted write-offs.
Payers conduct post-payment audits and demand refunds on previously paid claims. Without the data and documentation to defend against these audits, health systems return revenue they rightfully earned.
These aren’t isolated incidents—the only defense is technology that can match the scale and sophistication of payer operations.
Reve’s payer-trained AI identifies the true cause of every denial and generates evidence-based appeals that address specific payer criteria. Evaluate the results on 100 of your own appeals in a no-cost pilot.
Claims Review validates every claim before submission—catching the coding, policy, and documentation issues that guarantee denials. Stop losing money to avoidable mistakes.
Post-pay audit compares every remittance against your contracted rates. Identify underpayments, challenge incorrect adjustments, and recover revenue that would otherwise be written off.
Reve identifies clinical validation downgrades and partial denials that most teams don’t have the bandwidth to work. AI-powered review makes it economical to challenge every improper reduction—not just the large ones.
Pre-Surgery Review validates surgical cases at the point of scheduling—before the procedure happens. Prevent the high-dollar denials that hurt most.
Contract Copilot provides the granular data your managed care team needs to prove payer non-compliance at the contract level.
AI handles the research, analysis, and documentation. Your team focuses on decisions and exceptions.
No lengthy implementation projects consuming IT resources. Reve is live in 4 weeks, delivering value from month one.
HIPAA-compliant architecture. PromptWrx has completed a SOC 2 Type I examination. Complete audit trails. Your data stays protected.
Success-based pricing tied to results. You pay when we deliver recovered revenue. No hidden fees, no implementation surprises.
Real-time dashboards show what Reve is recovering—Track ROI from day one.
Reve generates the evidence your managed care and legal teams need—contract non-compliance documentation, underpayment patterns, and denial trend data for payer negotiations.