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Real-Time Payer-Provider Connectivity

• Instant Eligibility & Cost Transparency
• No more chasing down benefits or sitting on hold with payers. Our AI-driven system instantly verifies medical subscriber benefits, copays, deductibles, and co-insurance in real time before the patient appointment, providing exact pre-care estimates.”

 Intelligent Automated Prior Authorizations

• Invisible, Frictionless Approvals
• Leveraging advanced clinical language models, NetRev365 automatically matches provider documentation against trusted InterQual® evidence-based clinical criteria. We eliminate up to 45% of manual touches, accelerating prior authorization turnaround times by over 50% and stopping denials before care is delivered.”

Smart Claims Pre-Check & Automated Rules Engine

• Clean Claims on the First Submission
• “Our platform utilizes a machine-learning Claims Automated Rules Engine (CARE) to review submissions instantly. It automatically scans for missing attachments, miscategorized codes, and incomplete documentation, flagging errors before the claim is ever submitted to the payer.”

Optum Business

Specialized Medical Coding Intelligence

• Regulatory-Compliant AI Coding Compliance
• “Powered by the industry’s leading database of medical coding crosswalks and proprietary guidance. NetRev365 translates clinical documentation into precise ICD-10, CPT, and specialty-specific codes dynamically, drastically reducing human error and keeping pace with constant regulatory changes.”

Real-Time Claim Inquiry & Document Retrieval

• Total Transparency into Your Cash Flow
• “Track every dollar seamlessly. Our centralized AI framework handles secure, instant retrieval of Electronic Remittance Advices (ERAs), 835 documents, and claim status updates across hundreds of payers simultaneously, cutting down administrative work hours by the thousands.”

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