Protect revenue at every stage
Reimbursement risk enters the revenue cycle at different points — during care, before billing, and after claim submission. RevProtect applies the right controls at each stage to prevent loss, validate defensibility, and recover revenue when needed.
Concurrent Validation
Mid-cycle review & actionable recommendations
The most valuable time to address reimbursement risk is while a patient is still in care, while the clinical context, evidence, and care teams are still accessible.
RevProtect surfaces documentation and evidence gaps in real time, enabling teams to strengthen claims while there is still an opportunity to act.
While a patient is still in care, RevProtect:
- Scores level-of-care and medical necessity risk in near real time as documentation evolves
- Prioritizes the UR worklist of concurrent denials — not queue position or length of stay
- Flags cases for physician advisor escalation before discharge, not after
Outcome: Stronger claims before they’re ever coded, higher clean claim rates, and fewer downstream denials.
Pre-Bill Validation
Stop unsupported claims before they go out the door
As health systems adopt autonomous coding and AI-driven DRG optimization tools, a new risk has emerged: higher-weighted claims that lack adequate clinical support.
RevProtect acts as a final validation gate to ensure billed DRGs and codes stand up to payer scrutiny.
The risk: Optimization tools may increase reimbursement on paper, but they don’t ensure documentation meets payer evidentiary thresholds. Unsupported claims expose health systems to audits, downgrades, takebacks, and lost appeals.
Pre-bill validation helps organizations:
- Verify that clinical documentation supports all billed DRGs and codes
- Identify reimbursement risk introduced by autonomous coding or optimization tools
- Prevent submission of high-risk, unsupported claims
- Reduce exposure to payer audits, recoupments, and post-payment takebacks
Post-Bill Recovery & PFS
Focus effort where recovery is most likely
When prevention isn’t possible, RevProtect extends the same payer-specific intelligence into post-bill workflows. By predicting overturn probability and payer response, RevProtect:
- Prioritizes denials with the highest likelihood of overturn
- Predicts optimal follow-up timing based on payer behavior
- Generates evidence-backed appeal packages for clinical and DRG-related denials
PFS and denials teams can concentrate effort where it will have the greatest financial impact, reducing wasted work and accelerating time to cash.
Aligned to Outcomes, Not Promises
RevProtect is available through a performance-based engagement model designed to align incentives and reduce risk. Sift partners directly with health systems to tie success to measured reductions in denials and adverse payment outcomes (not activity, licenses, or usage).
Talk with us about whether a performance-based model makes sense for your organization.
