Reve: AI Automation to Dispute Claim Rejections

Submit Clean Claims the First Time. Automate Rejection Resolution. Maximize Your Cash Flow.

Every claim rejection costs healthcare providers valuable time and resources—slowing reimbursements, delaying revenue, and frustrating your billing team. Traditional revenue cycle management solutions wait until rejections happen and rely on manual rework. Existing AI-based solutions are often reactive, rule-based, rigid, and unable to anticipate frequent payer requirements and policy updates.

PromptWrx flips the script by proactively leveraging generative AI to improve your first-pass clean claim submission rate and automating the resolution of the most common rejections.

Why Reve is Different: Generative AI for Cleaner Claims

PromptWrx employs a state-of-the-art generative AI agent, Reve, to proactively validate each claim before submission, significantly boosting your clean claim rate and reducing rejections. And, if claims are rejected, Reve automatically identifies the issue, resolves missing or incorrect information, and resubmits seamlessly—no human intervention required.

The PromptWrx Difference:

• Traditional RCM Solutions: Manual processes, high operational cost, slow resolutions, and inconsistent clean claim rates.
• Legacy AI Solutions: Reactive, rigid rule-based logic, limited adaptability, partial automation that still requires significant manual rework, unable to adapt to changing guidelines and patterns.
• PromptWrx’s Generative AI Advantage: Proactive, adaptive pre-submission validation; intelligent automation of rejection resolution; dynamic response to policy changes; continually improved clean claim rates.

Key Capabilities: Proactive Submission and Intelligent Rejection Handling

Generative AI Pre-Submission Claim Checks

• Reve dynamically reviews claims before they’re submitted—identifying errors, missing details, coding inconsistencies, payer-specific formatting, and more.
• Our system automatically suggests and applies corrections, ensuring that your submitted claims align precisely with payer requirements and industry standards—before they’re submitted.

Automated Handling of Common Rejection Issues

• If claims are rejected, Reve immediately identifies the reason, if possible automatically corrects the claim, and rapidly resubmits the corrected version.
• Routine rejection reasons (such as demographic information errors, incorrect IDs, formatting issues, and incomplete eligibility documentation) are resolved automatically, requiring no manual touchpoints.

Continuous Real-time Learning & Adaptability

• Reve continuously learns from claim decisions, payer responses, and shifting reimbursement policies.
• Reve stays up-to-date with payer-specific requirements, state-specific billing guidelines, and the latest industry standards, continually improving accuracy and speed of submissions.

Immediate Impact for Your Revenue Cycle

By adopting PromptWrx, providers experience:

• Substantial Improvement in First-Pass Clean Claim Rates: Lower your rejection rate by proactively identifying and resolving claim issues prior to submission. Typical PromptWrx clients achieve a 40-60% improvement in first-pass clean claim submissions.
• Automated, Hands-Free Rejection Resolution: Eliminate manual effort and cost associated with common rejection issues. Automate repetitive corrections, freeing your billing and revenue cycle teams to focus on high-impact tasks.
• Accelerated Cash Flow & Reduced AR Days: Fewer rejections mean faster claim acceptance, quicker reimbursement, and more predictable cash flow. 
• Transparency & Actionable Insights: Real-time dashboards clearly track claims, rejection reasons, and automated resolution status, giving you complete visibility and control over your claim submission process.

Built by Insiders

Founded by former Health Insurance executives, PromptWrx understands exactly how payers review and reject claims. We leverage our insider expertise to proactively anticipate payer requirements and automate your claim management processes, turning rejections into automatic resolutions and ensuring maximum revenue capture.

Proactively Protect Your Revenue—Starting Today

PromptWrx moves beyond traditional and reactive claim management. It proactively addresses claim issues before submission and automates the resolution of common rejections. Reduce your rejections, eliminate unnecessary rework, and accelerate cash flow.

Schedule a Demo to See Reve in Action

Discover exactly how much Reve can reduce your rejection rates, save resources, and optimize your revenue cycle from claim submission to final payment.