Claims accuracy and cost control at scale.
Improve payment integrity. Control cost leakage.
Scale adjudication without adding internal burden.
RevHC supports employer-direct payers with claims adjudication and payment integrity expertise—strengthening accuracy, surfacing cost leakage, and expanding operational capacity across complex employer-specific plan designs.
A partner who can positively impact your margins and success.
90%
clean claims adjudicated within 14 days
99.7%
claims accuracy
93%
complex claims adjudicated within 10 days
>250K
monthly claims adjudicated, and growing…
How RevHC strengthens payer performance.
Built around three consistent pillars—adapted to employer-direct payer environments.
Revenue Risk Identification & Recovery
RevHC reduces payment error and cost leakage across claims adjudication and payment integrity—identifying both overpayments and underpayments while addressing systemic drivers of recurring issues.
In employer-direct models, this includes benefit configuration errors, authorization gaps, and contract misalignment across multiple platforms.
Impact:
Improved payment accuracy and reduced avoidable cost leakage.
Performance Stability During Transition
During expansion, volume spikes, or operational change, adjudication teams face capacity strain.
RevHC provides scalable adjudication and audit support—absorbing defined workstreams without disrupting internal operations or compliance standards.
Impact:
Operational continuity and quality stability at scale.
Scalable Revenue Control
As claims volume, employer mix, and plan designs evolve, our support adapts.
RevHC flexes between claims operations, payment integrity review, and root-cause remediation—guided by analytics and performance insight.
Impact:
Scalable support aligned to changing accuracy, cost-control, and growth priorities.
Scaled multi-state expansion without compromising quality.
Employer-Direct Payer | Multi-Platform Adjudication Environment
Challenge
The organization was expanding into a new state while operating across multiple adjudication platforms and employer-specific plan configurations.
Internal teams were stretched by cross-training demands, benefit nuance, authorization complexity, and the need to maintain cost control without degrading quality.
Leadership required scalable capacity and cost-effective growth without compromising adjudication standards or compliance.
RevHC Engagement
- Scaled adjudication capacity to support state expansion
- Integrated into multiple platform workflows
- Provided rapid cross-training across employer-specific plan designs
- Implemented quality controls and governance to maintain performance
MAINTAINED TURNAROUND TIME (TAT) DURING EXPANSION
INCREASED CLAIMS VOLUME SUPPORTED PER MONTH
IMPROVED QA PASS RATES AND PROCESSING CONSISTENCY
DELIVERED COST-EFFECTIVE SCALE WITHOUT SACRIFICING PAYMENT ACCURACY
ESTABLISHED GOVERNANCE CONTROLS TO SUPPORT ONGOING GROWTH
Why employer-direct payers choose RevHC
Not just staffing support.
A scalable claims and payment integrity partner.
- We scale adjudication capacity quickly across states and platforms
- We bring deep claims operations and payment integrity expertise
- We adapt to employer-specific benefits and authorization nuance
- We reduce cost leakage without compromising compliance
- We deliver measurable, accountable performance
Purpose-built to strengthen claims accuracy and cost control in employer-direct models.