Intelligent Revenue Cycle Agents — Ready to Embed in Your Platform

Reve’s API suite gives RCM platform vendors, EHR integrators, and health system development teams direct access to the most advanced AI agents in healthcare revenue cycle management.

Purpose-Built Agents for Every Stage

Each API endpoint invokes a specialized AI agent backed by 200,000+ payer policies, tenant-specific contract intelligence, and millions of reference sources.

Pre-Service Review

Validates procedures at point of scheduling across 8 dimensions: PA status, medical necessity, coding accuracy, contract coverage, payer policy compliance, and more.

Input
Scheduling form (PDF), clinical records (PDF), PA letter (PDF)

Response
Structured APPROVE/HOLD report with action checklist, analysis, and policy citations

Pre-Submission Claim Review

Analyzes claims before submission to catch errors, coding issues, missing documentation, and payer-specific compliance gaps that would trigger denials.

Input
837P/837I, clinical records (PDF), payer correspondence

Response
Validation report with issue severity, corrective actions, and recommendations

Post-Submission Claim Analysis

Evaluates partial pay, denied or rejected claims against coding guidelines, payer policies, contract terms, and clinical documentation to determine optimal recovery path.

Input
835, 837P/837I, clinical records (PDF), EOB

Response
Root cause analysis, overturn probability score, and recommended action

Appeal Analysis & Generator

Builds the strategic case and produces a complete, submission-ready appeal letter with payer-specific logic, policy citations, contract language, and supporting evidence references.

Input
835/denial notice, clinical records, payer contract

Response
Professional appeal letter (structured text) + evidence summary + submission guidance

Policy & Contract Analysis

Answers payer policy, coding, and medical necessity questions using 200,000+ policies. Queries tenant-specific payer contracts for fee schedules, authorization requirements, and terms.

Input
Natural language query + optional claim context (837, PDF, codes)

Response
Cited answer with policy/contract references, effective dates, section references

Enterprise-Grade Document Intelligence

Healthcare documents are messy. Reve’s document processing engine, embedded in each API, handles the full complexity of real-world healthcare documentation—so your platform doesn’t have to.

  • 10,000+ page medical records with mixed content — no file size limits
  • Auto-classification of document types within mixed PDFs
  • Handwriting recognition from clinical documentation and scanned forms
  • Structured extraction from UB-04, CMS-1500, and standard forms
  • Faxed documents and poor-quality scans that defeat conventional OCR
  • Native EDI parsing: 835, 837P/I, 277, and other X12 formats
  • HIPAA-compliant with full encryption and audit trails

Integration Flow

  1. SEND
    POST documents (PDF, EDI, images) and instructions to the agent endpoint via REST API.

  2. PROCESS
    Reve’s AI agent classifies, extracts, and analyzes using vast reference, policy, and contract knowledge bases.

  3. RECEIVE
    Get structured JSON responses with analysis, recommendations, citations, confidence scores, and appeal letters.

White-Label Ready. Flexible Models.

Embed Reve’s AI agents directly into your platform under your brand. All API responses are delivered as structured data you control—present results in your UI, with your branding, on your terms.