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RevOn delivers technology-enabled healthcare solutions built around the operational and business requirements of US healthcare organizations. Our solutions span Claims Administration, Benefits and Provider/Network Configuration, Business Rule Configuration, Member and Provider Operations, Claims Testing & Quality Assurance, Healthcare IT Support, RCM, Data Validation, Reporting and Analytics.
Flexible Delivery Options: We combine healthcare domain knowledge with configuration, testing, process management and technology capabilities to address complex healthcare workflows and operational challenges. Our solutions can be delivered as specialized services, dedicated teams, managed operations or end-to-end process support.
End-to-end claims lifecycle processing, auto-adjudication configuration, fee schedule setup, and claim exception management.
Translating complex payer policies, CMS guidelines, and state regulations into precise, automated system logic.
Structuring commercial, Medicare, and Medicaid benefit plans, accumulator tracking, and copay structures.
Managing contract fee schedules, provider taxonomy rules, network tiering, and roster validation.
Comprehensive test case creation, regression testing, migration validation, and adjudication audit for health plans.
EDI 834 enrollment processing, eligibility verification, premium billing support, and member record maintenance.
Cleaning and updating provider directories, address validation, TIN/NPI validation, and network adequacy reporting.
Back-office operational support, grievance and appeals processing, and operational reporting for payer leadership.
Claims turnaround dashboards, auto-adjudication rate tracking, medical loss ratio (MLR) insights, and audit reports.
End-to-end financial operations management designed to improve reimbursement rates, reduce AR days, and eliminate cash leaks.
Precision charge entry, patient statement generation, insurance claim creation, and primary/secondary billing.
Certified AAPC/AHIMA coders ensuring compliant coding, modifier selection, and maximum code specificity.
Clearinghouse error scrubbing, 24-hour claim submission, rejection management, and payer status tracking.
Rapid denial root-cause analysis, customized appeal letter submission, and preventative front-desk workflow training.
Old AR recovery projects, insurance follow-up calling, payment posting, and credit balance cleanup.
Front-desk virtual assistance, prior authorization handling, patient eligibility verification, and practice performance audits.
Dedicated Tier 1-3 helpdesk, EHR/PM platform support, core payer application maintenance, and incident management.
Cleaning and auditing healthcare data, EDI X12 transaction compliance, and cross-system migration checks.
Optimizing intake-to-payment workflows, task queue management, SLA tracking, and staff productivity tools.
System Integration Testing (SIT), User Acceptance Testing (UAT), regression automation, and release testing.
24/7 system monitoring, batch processing error management, patch release verification, and database maintenance support.
RPA bots for repetitive eligibility checks, automated claim status inquiry, and streamlined document routing.
TAILORED SOLUTIONS
Speak with our technical and operational leadership to design a solution customized to your platform and business goals.
