Connect directly to your clearinghouse (Waystar, Availity, Change). Our headless engine ingests daily EDI 835 remittances, synthesizes clinical evidence packets via FHIR, and transmits policy-cited EDI 275 appeals on 100% contingency.
Observe how incoming EDI 835 remittance rejections are ingested, cross-referenced with clinical notes, and overturned in real time.
Calculate your facility's projected commercial recovery based on actual payer denial benchmarks and autonomous overturn capacity.
Net newly recovered cash per month
Zero fee due if $0 recovered from past 90 days.
Zero manual portal uploads. Your team gets a read-only audit ledger of every dollar recovered and automatically deposited.
| Claim ID | Commercial Payer | Specialty Procedure | Original Denial | Billed Amount | Recovered EFT | Overturn Status |
|---|---|---|---|---|---|---|
| #CLM-89241 | UnitedHealthcare | L4-L5 Lumbar Arthrodesis (22612) | CO-50: Medical Necessity | $46,500.00 | $38,400.00 | REMITTED (TRN-01) |
| #CLM-89255 | Aetna Commercial | Total Knee Arthroplasty (27447) | CO-16: Prior Auth Detail | $31,200.00 | $29,100.00 | REMITTED (TRN-88) |
| #CLM-89312 | Cigna Healthcare | Rotator Cuff Repair Complex (29827) | CO-50: Conservative Care | $18,400.00 | Awaiting Payer | EDI 275 DISPATCHED |
| #CLM-89340 | Humana Choice | Spinal Neurostimulator Implant (63650) | CO-197: Precert Protocol | $52,000.00 | $44,800.00 | REMITTED (TRN-42) |
Replaces manual portal uploads and generic appeal letter drafting with continuous machine-to-machine data exchanges.
The listener connects directly to your clearinghouse (Waystar, Availity, Change Healthcare) via read-only SFTP or REST API. It ingests daily 835 remittance files, isolating high-AOV commercial denials within milliseconds.
The pipeline queries your EHR via read-only SMART on FHIR endpoints to extract operative reports, lab records, and clinical imaging, cross-referencing payer Clinical Policy Bulletins (CPBs) to construct legally unassailable appeal briefs.
Final appeal dossiers transmit straight back into the clearinghouse via native EDI 275 transactions. Overturned funds deposit directly into the clinic's operating accounts with automated ledger reconciliation.
Side-by-side comparison between traditional manual follow-up and our headless clearinghouse listener.
| Dimension | In-House Biller Staff | Traditional Outsourced RCM | RevEngine Autonomous EDI |
|---|---|---|---|
| Speed to File Appeal | 14 – 30 Days | 7 – 14 Days | < 24 Hours |
| Upfront Capital Risk | $240k+ Salaries & Benefits | Monthly Retainers + Hourly | 100% Contingency ($0 Upfront) |
| Daily File Throughput | 8 – 12 Claims / Specialist | Capped by Shift Labor | Unlimited Batch Concurrency |
| Payer Policy Rigor | Generic Form Letters | Template Appeal Generators | Target CPB Rules & Operative Excerpts |
| Staff IT Overhead | Heavy Manual Portals | Bi-Weekly Status Calls | Zero Portal Logins Required |
We securely scan your past 90 days of commercial clearinghouse write-offs to identify recoverable capital awaiting appeal.
Your countersigned Business Associate Agreement and secure SFTP credential provisioning instructions have been dispatched to your executive email.
Everything clinical finance officers and compliance committees need to know before connecting.