End-to-End AI for Medical Coding, Claim Scrubbing & Denial Prevention
Built for healthcare organizations navigating tightening operating margins and complex payer rules. Revedy unifies autonomous and human-in-the-loop coding, pre-bill NCCI and medical necessity validation, and evidence-based appeals into a single, HIPAA-compliant platform.
95%+
Clean Claim Rate Target
Catch coding, modifier, and LCD/NCD errors pre-bill to maximize first-pass payer acceptance.
80–90%
Workflow Automation
Accelerate chart-to-claim velocity and transform coders into high-output strategic auditors.
50+
Authoritative Payer Sources
Continuously updated CMS, NCCI, MUE, and commercial payer policy knowledge graph.
Lower A/R
Reduced Days in A/R & Cost to Collect
Eliminate DNFB bottlenecks, prevent avoidable rework, and accelerate net collections.
Four Integrated Modules Across the Revenue Cycle
Replace disconnected point solutions with a continuous revenue intelligence layer that protects reimbursement from initial clinical documentation through final payer adjudication.
Autonomous & HITL Medical Coding (ICAT)
Extract accurate CPT, ICD-10-CM, time-based units, and modifiers directly from complex operative reports and clinical notes—backed by verbatim clinical citations.
- Side-by-side source evidence in the Intelligent Coding Audit Tool (ICAT)
- Configurable ICD-10-CM modes (Strict Documentation vs. CDI Opportunity Flagging)
- Automated time-based unit math and RVU sequencing
Pre-Bill Claim Scrubbing & Payer Rule Engine
Stop claim denials before submission. Revedy validates every claim against federal coding rules, payer-specific policies, and your custom provider logic.
- Automated NCCI Procedure-to-Procedure (PTP) & Medically Unlikely Edits (MUEs)
- ICD-10-CM Excludes1 and Excludes2 conflict resolution
- Modifier validation (e.g., 59 vs. XU/XS/XE, 26/TC, 25) to prevent unbundling denials
Real-Time Medical Necessity Validation
Cross-reference clinical documentation against 50+ authoritative payer and regulatory sources in real time to verify coverage criteria prior to billing.
- Live Medicare LCD/NCD and commercial medical policy matching
- Automated identification of missing CC/MCC and secondary diagnoses
- Claim-level denial risk scoring and proactive CDI queries
Automated Payer Response & Appeals
Turn hours of manual appeal drafting into a structured, repeatable workflow. Ingest payer denials and clinical records to generate audit-ready appeal packages.
- Automated parsing of 835/EOB CARC and RARC denial reason codes
- Direct citation of patient chart evidence alongside payer coverage policies
- Standardized, compliant appeal letters ready for coder or clinician sign-off
Built to Fit Your Workforce & Security Posture
Whether your team needs an interactive coder audit workstation, headless API automation inside your EHR, or strict private-cloud data residency, Revedy adapts to your operational model.
ICAT Web Workstation (Human-in-the-Loop)
Empower certified coders and QA auditors with an interactive workstation featuring highlighted clinical evidence, bulk claim queues, and one-click validation to elevate workforce productivity.
Headless REST API Integration
Embed autonomous coding, real-time claim scrubbing, and medical necessity checks directly into your existing EHR, practice management system, or proprietary billing pipeline.
SaaS 2.0, Private Cloud & On-Premises
Deploy in Revedy’s HIPAA-compliant, SOC 2 Type II cloud or run containerized services inside your own AWS, Azure, or GCP VPC so PHI never leaves your environment.
Service-as-a-Service (SaaS 2.0) Customization & Rapid Pilots
Revedy configures payer-specific and surgeon-specific rules to your exact historical claims and EHR workflows—delivering measurable ROI within 60 to 90 days.
Purpose-Built for High-Complexity Specialties & Care Settings
Generic coding tools fail on specialty nuances. Revedy’s rule engines and clinical language models are tailored to the coding guidelines, modifiers, and reimbursement models of complex specialties.
IONM & Neurodiagnostics
Automate multi-hour time-based unit calculations, complex multi-modality CPT extraction, and technical/professional component modifiers for intraoperative neuromonitoring.
Cardiology & Heart / Vascular
Capture complex catheterization, stent, electrophysiology, and vascular hierarchy rules while preventing prior authorization and medical necessity denials.
Ambulatory Surgery Centers (ASCs) & Surgery
Eliminate revenue leakage across multi-procedure operative reports with automated NCCI bundling validation, modifier precision, and rapid surgical chart turnaround.
Clinical & Specialty Diagnostic Labs
Validate toxicology, molecular, and high-volume reference lab panels against payer-specific LCD/NCD frequency limits and diagnosis-to-panel medical necessity rules.
Home Health & Waiver-Based Telehealth
Enforce state waiver rules, telehealth place-of-service codes, and complex home health documentation requirements to slash denials and scale distributed care.
Evaluation & Management (E/M) & Outpatient
Standardize Medical Decision Making (MDM) scoring, prevent systematic undercoding or upcoding, and close charge capture gaps from patient intake to reimbursement.
FQHCs & Community Health Centers
Automate Prospective Payment System (PPS) billing, wrap-around payment capture, same-day encounter rules, 340B compliance, and expanding behavioral health programs.
RCM Companies & HIM BPO Partners
Move beyond labor arbitrage. Clear legacy claim backlogs during client onboarding, automate 80–90% of routine coding, and expand EBITDA margins without adding headcount.
Additional Supported Specialties & Workflows
Ready to See Revedy on Your Own Clinical Charts?
Schedule a technical walkthrough with our healthcare RCM team, test the live sandbox, or review our reference architecture and security documentation.