Claims review, read before it's submitted

Read closely enough to survive review.

MedReview ingests the full claim packet — clinical notes, prior authorization, billing codes — and flags exactly what a payer would deny, before you submit. Every finding traced to the page it came from.

  No cost. No commitment. Your own case data.

Risk signals

Missing authorization
No prior-authorization number found for the billed procedure — this is the single most common reason a claim like this gets denied on first pass.

Cited in the source

CPT 627041
$25.7B1
spent by U.S. providers on claims adjudication in 2023 — up 23% in a single year.
11.8%2
of claims are denied on the first pass, up from 10.2% two years earlier.
0.3%3
of denied ACA marketplace claims ever get appealed by the patient.
1. Premier Inc., 2023 — 2. Kodiak Solutions / HFMA, 2024 — 3. KFF, "Claims Denials and Appeals in ACA Marketplace Plans," 2024

The problem

The paperwork fight costs more than the care.

A denial doesn't happen because the care was wrong. It happens because nobody had time to read the entire packet — clinical notes, prior authorization, billing codes — closely enough to catch what a payer's reviewer would catch.

Providers

Every late-discovered denial widens the cash-flow gap — and the cost of reworking a claim keeps climbing faster than the cost of care itself.

Billing & RCM teams

Staff time gets burned re-reading full packets one claim at a time, instead of scaling with volume — the actual ceiling on how many claims one coder can clear.

Patients

Only three-tenths of one percent of denials ever get appealed. Most legitimate care simply goes unpaid, and no one gets a clear answer why.

How it works

One packet in. A defensible answer out.

01

Ingest

Drop in the full case packet — claim, clinical notes, prior auth, EOB. MedReview reads it as one case, not documents in isolation.

02

Validate

Every code is checked against real reference data — ICD-10, CPT/HCPCS, CARC/RARC — before any AI reasoning runs.

03

Explain

Missing authorization, upcoding risk, duplicate claims — flagged in plain language, with a confidence score, not a red X.

04

Prove

Every finding links back to the exact page it came from. Ask it anything about the case and get a cited answer.

See it in action

Watch a real case get reviewed.

The same walkthrough we give prospects live — risk signals, cited billing codes, and the audit trail, on a real case.

Product walkthrough — coming soon

Inside the cockpit

Built to be checked, not just trusted.

Three moments from the actual reviewer workspace — the same three we walk prospects through live.

Risk signals, explained

Five checks run on every case. Each one expands into why it fired.

Missing authorization
No prior-auth number on file for the billed procedure.
Upcoding risk
Duplicate claim
Late filing

Every fact, cited

Billing codes grouped by system, each one linking to its source page.

CPT  62704¹
ICD-10-CM  E11.9²F33.1²
ICD-10-CM  G89.29²M54.50²

A defensible record

Every pipeline step, timestamped — the answer when someone asks “how did you get here?”

Document uploaded and queued for processing
13:01:42
Pipeline started — ingest & normalize
13:01:51
Adjudication signals & recommendation available
13:02:17

Why not just —

Automation reads data. MedReview reasons about it.

Document automation toolsMedReview
DepthMoves data between fieldsClinical NLP + code validation against a real reference database
CoverageBuilt for one side of the claimReviewer and provider workflows, on the same case data
AnswersFree-floating generated textEvery answer cited to the exact source page
ArchitectureLLM-only reasoningDeterministic rules first; AI layered on top to explain

We don't just automate the paperwork — we catch the clinical and coding reasons claims get denied, before they're submitted, and we prove it with citations.

Trust

Deterministic where it counts. AI where it helps.

Coding and compliance checks run first against real reference data — CPT, ICD-10, CARC and RARC. AI is layered on top only to reason and explain, not to invent facts. That ordering is deliberate: it's what makes every recommendation traceable back to something you can verify yourself.

Built on HIPAA-eligible cloud infrastructure
Business Associate Agreement before any real patient data is processed
Full audit trail logged on every case, every finding
Reference-data-first validation, AI-explained second

Pricing

Pick the model that fits how you buy.

Per-claim

$2–8 / claim

Flat fee per case processed. Easiest to understand and approve for small clinics and low-volume practices.

Seat-based

$150–400 / seat / mo

Per-reviewer monthly license. Best fit for mid-size RCM and billing companies with dedicated coding staff.

Outcome-based

8–15% of value

A share of denial value prevented or recovered. For larger accounts once pilot data is in hand.

Every account starts on a free pilot — 50 to 100 of your own cases, no cost — before you pick a tier.

Right now

We're running free pilots with a handful of teams.

MedReview is working with early design partners to validate real denial-rate and turnaround-time impact before we publish a single case study. If you want to be one of the next few, here's exactly what that looks like.

1 Send 50–100 of your own real case packets. No cost, no commitment.
2 We run them through the full pipeline and hand back what it caught.
3 You compare it against your own current denial rate and review time.
4 Decide from there — no pressure, no pre-committed spend.
Start a free pilot

or call +91 70420 79171

Run it on your own claims.

Free. No commitment. See exactly what it catches.

+91 70420 79171