Automated Revenue Integrity for IONM
Revedy’s AI platform prevents revenue leakage and ensures compliant reimbursement for complex neurodiagnostic procedures. We automate the entire IONM revenue cycle—from charge capture to denial management—to protect your operating margins.
Foundation: Audit-Proof Procedural Validation
Our process starts by creating a single source of truth for every case, eliminating the data discrepancies that lead to costly denials.
Unified Clinical & Device Data
- Unified Data Ingestion: We ingest the complete case file—operative notes, technical reports, and the raw, structured data output from the monitoring system.
- AI-Powered Cross-Validation: Our engine cross-references the physician's narrative against electronic device data, ensuring every monitored modality is electronically verified and clinically supported.
- Denial-Proof Record: This creates a single, validated, and audit-proof record of the procedure, forming an unassailable foundation for clean claim submission.
The Four Pillars of IONM Revenue Integrity
1. Automated & Compliant Charge Capture
Our AI analyzes the validated case file to assign correct CPT codes for every modality. It accurately calculates time-based units and generates compliant professional (26) and technical (TC) claims, plugging revenue leakage and eliminating costly human errors to improve coding accuracy.
2. Intelligent Payer Policy Adherence
To maximize the clean claim rate, our engine applies a layer of payer-specific intelligence. It automatically adjusts codes to meet the unique requirements of major payers like Medicare (e.g., G0453) and commercial plans, ensuring the submitted claim is optimized for first-pass payment.
3. Proactive Medical Necessity Validation
We stop denials before they happen. Our platform automatically cross-references procedure and diagnosis codes against our comprehensive database of Medicare (LCD/NCD) and commercial payer policies. This pre-submission check ensures every claim meets the payer's medical necessity criteria.
4. Automated Denial & Appeals Management
When a denial occurs, our system automates the response. The AI analyzes the denial reason, retrieves the validated clinical evidence from the case file, cites the relevant rule in the payer's own policy, and drafts a precise, evidence-based appeal that dramatically increases overturn rates.
The Outcome: Optimized Financial Performance
Revedy transforms a complex, manual process into an automated, intelligent workflow that directly impacts your most critical RCM KPIs.
The result is a higher clean claim rate, a lower cost to collect, and an increased net collection rate, strengthening the financial health of your neurodiagnostics service line.