The revenue cycle, seen the way a CFO needs to see it.
Claims processed today
12,431
simulated feed
Dollars at risk flagged
$412K
1,284 claims
96 prevented
38 drafted
$128K found
It ties five things together.
Prevention upstream, recovery downstream, and the governance that makes both defensible.
Payer clarity by plan, cohort, and trend
Drift alerts from your own remittance data, typically about 11 days from the first inbound signal. You see the payer change before the bulletin does.
Prevention-first workflow
Leading indicators, from authorization misses to new payer policy versions, trigger pre-bill checks and tasks before revenue is at risk.
Operational focus on the right cases
A daily underpayment queue ranked by dollars recoverable, so scarce reviewers work the cases that pay for the day.
Financial lift and recovery
Up to an 80% appeal overturn rate on the cases Neurex pursues, and a $0-upfront option for recovery engagements: paid on what is recovered.
Trust, governance, and audit
Human-in-the-loop on consequential actions, tenant-scoped learning, and audit-ready trails behind every number on the screen.
The numbers your board asks about, segmented the way your operators work.
Five prevention KPIs, every one segmented by payer, denial category, and service line. Underneath them, the leading indicators that fire before the KPI moves.
Authorization and precert misses
Flagged before submission, with the task routed to the owning queue.
Eligibility and coverage mismatches
Caught at intake instead of surfacing as front-end denials.
Documentation missing at submission
The gap is named while the record is still open to fix.
High-risk DRGs and service lines
Concentration risk surfaced by payer, category, and service line.
New payer policy version detected
Summarized with a severity score and tied to the impacted claims.
Executive KPI board
Segmented by payer, denial category, service line
7 dashboards live on day one · typical deployment
From retrospective reporting to payer foresight.
Most reporting tells you what a payer did last quarter. Revenue Recovery Central tells you what a payer started doing last week, and what it puts at risk.
Drift, from your own remittances
Documented detection-to-alert window of about 11 days from the first inbound signal; typically about 6 days before the payer publishes the bulletin.
Deviations that carry dollars
30, 60, and 90-day rolling baselines per payer and claim shape. A statistically significant deviation triggers an alert with dollars at risk and a suggested action.
Policy intelligence
NCD, LCD, and payer bulletin changes summarized with a severity score, tied to impacted claims, codes, and service lines.
Payer foresight
Drift alert · from your own remittances
Observation-stay denials trending up
Payer M04 · 95% CI deviation vs 30/60/90-day baseline
Alerts land typically about 6 days before the payer publishes the bulletin; in one documented pattern, 17 days before. Documented observations, not an SLA. The revenue cycle lead approves the action from the alert.
A zero balance is not a closed account.
Denied claims worth a second look, services rendered but never billed, suboptimal billing, contract underpayments, and plan mapping errors: the five places money hides, worked from one ranked queue.
Continuous, not quarterly
Zero-balance validation runs across every paid claim, continuously, instead of a quarterly audit sample.
Variance, categorized
Short pays are root-caused into bundling, downcoding, fee-schedule mismatch, or modifier impact, with full adjustment-code drill-down.
Fast cash first
Corrected claims from missed charge capture typically reprice without human adjudication and pay in roughly 3 to 5 weeks.
ZBR + Underpayment Finder
Daily queue · ranked by dollars recoverable
Every paid line is compared against the contracted rate per code and payer, with full adjustment-code drill-down and an audit trail to the underlying remittance. Values shown are illustrative.
Prevention you can hold accountable.
Measure, Diagnose, Intervene, Verify: every prevention action is tied to the outcome it changed.
illustrative demo data
verified outcomes feed the next measure
What good looks like: denial rate trending down, faster cycle times, a higher overturn rate, fewer nonrecoverable front-end denials, and a clear attribution story linking prevention actions to outcomes.
Deployment
Weeks to signal, not quarters.
Across ~$4.5B in A/R under active management and 11 production healthcare organizations.
Typical deployment experience, not a contractual SLA · $0 up front for recovery engagements
What CFOs ask first
The KPI set, the forecast, and the timeline, answered plainly.
Five, segmented by payer, denial category, and service line: first-pass rate; initial denial rate in both volume and dollars; denial write-offs as a percentage of net revenue; time from initial denial to appeal; and the percentage of initial denials overturned. Leading indicators sit underneath them: authorization and precert misses, eligibility and coverage mismatches, documentation missing at submission, high-risk DRGs and service lines, and new payer policy versions detected.
A decision-support view of the recoverable dollars in your book. The Revenue Recovery Forecast projects recovery from the daily underpayment queue, denial second looks, and zero-balance review, segmented by payer and category. Forecasts inform decisions; they are not guarantees.
In typical deployments, the first actionable insight lands in 8 weeks and measurable lift in 12, with 7 dashboards live on day one. Corrected claims from missed charge capture typically reprice without human adjudication and pay in roughly 3 to 5 weeks. This reflects typical deployment experience, not a contractual commitment.
Powered by CIRCLE: Clinical Intelligence in Revenue Cycle reinforcement Learning Engine (patent-pending), with security and governance built in.
Every recoverable dollar, recovered.
See it on your own denials: a pilot with success criteria you set, and a $0-upfront option for recovery engagements.
Paid on recovered revenue · Human-in-the-loop on consequential actions