How Revedy Builds a Data-Driven Appeal
Transform the appeal process from a manual struggle into an intelligent, automated workflow that wins.
The Manual Way (Before Revedy)
Time-Consuming Research
Manually digging through clinical notes and payer websites.
Confusing Payer Rules
Policies are often 100+ pages long and cover many procedures.
Weak, Generic Arguments
Using the same template for every appeal is ineffective.
Low Success Rate
Payers easily dismiss appeals that aren't specific and evidence-backed.
IS TRANSFORMED INTO
The Revedy Way (After Revedy)
Automated Evidence Gathering
The AI instantly analyzes all clinical notes and payer communications.
Pinpoint Policy Extraction
Our engine finds the exact policy rules relevant to your case, ignoring the noise.
Case-Specific Arguments
Every appeal is custom-built, quoting the payer's own rules as evidence.
Data-Driven Success
Appeals are so well-supported and specific that they are hard to deny.
How It Works: From Raw Data to Winning Argument
Part A: We Gather the Essential Evidence
1. Your Clinical Documentation
We analyze all case files (Op notes, reports, etc.).
Output: The "Procedure Context"2. The Payer's Communication
We read the denial letter to identify the payer, plan, and state.
Output: The "Payer Context"3. Our Payer Policy Library
We access our comprehensive library of payer rules and guidelines.
Output: The "Policy Document"Part B: The Revedy AI Engine Connects the Dots
1. Define Case: Uses the "Procedure Context" to understand the specific medical scenario.
2. Identify Rules: Uses the "Payer Context" to select the right "Policy Document".
3. EXTRACT RELEVANCE (The Key Step):
The AI reads the entire policy and pulls out **only the specific paragraphs and rules** that apply to this exact case.
Part C: The Output is a Precise, Evidence-Based Appeal
Generated Appeal Letter
- Clinical Justification: Cites evidence directly from your clinical documentation.
- Medical Necessity Argument: Quotes the payer's own rules back to them using the extracted policy text.
- Evidence Summary: Lists all sources used to build the argument, creating an audit-proof record.
The Result: A Smarter, Faster, More Effective Process
Solves Research
Automates the gathering of clinical and policy data.
Solves Confusion
Pinpoints the exact rules that matter, ignoring the rest.
Solves Generic Arguments
Creates a unique, evidence-based appeal for every case.
Drives Success
Makes the argument so specific and well-supported it's hard to deny.