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AI-Powered Medical Necessity

Stop Fighting Denials. Start Building Bulletproof Claims.

Medical necessity is a maze of payer rules, hidden policies, and dense clinical notes. Revedy's AI gives you the clear path to payment.


Does This Look Familiar?

The LCD Labyrinth

Manually sifting through the CMS portal, trying to find the right Local Coverage Determination (LCD) and its list of covered diagnosis codes.

The Commercial Black Box

Logging into five different payer portals to hunt down a specific commercial policy, only to find it’s a 150-page PDF with no search function.

The Documentation Deep-Dive

Scouring hundreds of pages of clinical notes, hoping to spot a documented condition that matches the payer's obscure, hard-to-find rules.

The Inevitable Result

Submitting a claim that feels right, only to get a 'Not Medically Necessary' denial, forcing you to start the whole painful research process over again.


From Chaos to Clarity in Seconds

Step 1: We Ingest the Entire Case File

Simply provide the case. Our AI instantly consumes all relevant documents—the clinical notes, denial codes from the EOB, and identifies the specific payer, whether it's Medicare or a commercial plan like UHC.

Step 2: We Pinpoint the Source of Truth

Our platform automatically connects to the right policy. For Medicare, it pulls the governing LCD/NCD. For commercial payers, it searches our vast policy library to find the exact medical policy that applies. No more hunting.

Step 3: We Uncover the 'Golden' Diagnosis

This is where Revedy changes the game. Our AI reads the clinical notes in the context of the payer's rules and frequently finds a documented diagnosis that provides perfect justification but was missed during initial coding.

Step 4: We Deliver the Bulletproof Recommendation

You get a simple, powerful output: the optimal CPT and ICD-10 combination, an approval score, and direct quotes from the payer's own policy to back it up. Submit with total confidence.


The Result: Faster, Smarter, More Profitable

Eliminate Research Time

Automates the manual work of finding and reading payer policies.

Reduce Med-Nec Denials

Builds claims that are compliant with payer rules from the start.

Increase First-Pass Rate

Gets more claims paid correctly on the first submission.

Create Audit-Proof Records

Every decision is backed by documented evidence from the payer's own policies.

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