Predictive Revenue Intelligence

Catch the denial before you submit the claim.

NexRev sits on top of the EHR you already use. It checks eligibility, coding, and billing rules before a claim goes out the door, so fewer of them come back.

  • HIPAA-first architecture
  • Read-only EHR access
  • Encrypted in transit & at rest
  • Built by RCM operators

The Problem

Denials are rising, and most practices can't see them coming.

More providers than ever now see over 10% of their claims denied, and the industry spends billions a year re-filing claims that should have been clean the first time. Enterprise health systems have whole departments and AI tools to catch this before it happens. For a small practice, that is real revenue walking out the door on claims that were fixable in seconds.

41%
of providers have a >10% denial rate
$20B+
spent annually on denial rework, industry-wide
14%
of providers use AI for denials today

Figures from industry RCM research (Premier Inc., Black Book Research, HFMA/AKASA).

What NexRev Does

An intelligence layer, not another system to run.

You keep your EHR, your clearinghouse, and your billing workflow. NexRev reads what is already there and checks it before you submit, so problems get caught in seconds instead of weeks later in a denial letter.

01

Eligibility & benefits

Real-time eligibility and coverage checks, before the appointment.

02

Coding intelligence

ICD-10 and CPT validation, so the codes match the visit.

03

Medical necessity & billing rules

Catches bundling, modifier, and coverage-rule issues before they become denials.

04

Claim readiness

One clear signal for every claim: ready to submit, or not, and the reason why.

How It Works

Sits on top. Doesn't replace anything.

There is no migration and nothing new for your front desk or billers to learn. NexRev connects once and works quietly in the background.

  1. 1

    Connect

    NexRev links to your existing EHR with read-only access. No migration, and no new system for your staff to learn.

  2. 2

    Check

    Every claim is checked against eligibility, coding, and billing rules before it is submitted.

  3. 3

    Catch

    You get a clear, specific flag on anything likely to be denied, and the reason, while there is still time to fix it.

J3490Flagged
no prior auth on file
J3490Clean
auth attached, ready

What We Catch

The denials that quietly add up.

Most denials trace back to a short list of preventable issues. NexRev flags them while the claim is still on your screen, with the specific fix, not a generic error code weeks later.

99213Flagged

Missing modifier 25 on a same-day E/M visit.

Add modifier 25 before submission.

J3490Flagged

No prior authorization on file for this drug code.

Attach the auth, or hold the claim.

97110Flagged

Coverage lapsed for the date of service.

Re-verify eligibility before billing.

80053Flagged

Panel component billed separately, will be bundled.

Bill the panel code instead.

99214Flagged

Level of service not supported by the documentation.

Downcode, or add supporting notes.

20610Flagged

Missing laterality modifier on a joint injection.

Add LT or RT before submission.

Illustrative examples of common denial reasons. Actual checks depend on payer and plan rules.

Integrations

Works with the EHR you already run.

We are building direct, read-only integrations with the systems independent practices use most. If yours is not here yet, tell us on the form and we will prioritize it.

  • athenahealth logoathenahealth Building
  • Practice Fusion logoPractice Fusion Building
  • eClinicalWorks logoeClinicalWorks Planned
  • Elation Health logoElation Health Planned
  • DrChrono logoDrChrono Planned

Integrations in progress. Product names and logos shown are the platforms we are building for and do not imply any endorsement or partnership.

Security & Compliance

Built HIPAA-first, not HIPAA-later.

Checking claims means handling protected health information. We designed NexRev around that from the first line of code, with the safeguards a practice should expect before anything touches patient data.

Read-only access

NexRev never writes to your EHR or submits on your behalf. It reads claim data to check it, and nothing more.

Encryption everywhere

Data is encrypted in transit and at rest using industry-standard protocols.

Access controls & audit logs

Role-based access and full audit logging on every record NexRev touches.

Tenant isolation

Your data is logically isolated from every other practice on the platform.

Least-data principle

We process only the fields needed to check a claim, and nothing we do not need.

Compliance in progress

Formal HIPAA documentation and independent legal review are underway ahead of general availability.

NexRev is pre-general-availability. Formal certifications are in progress, and we are glad to walk design partners through our current safeguards in detail.

Built For

Independent practices, not enterprise health systems.

NexRev is built for solo and small physician and dental practices, usually 1 to 10 providers, who do not have a dedicated revenue cycle team. Just a billing person and an EHR that does not catch these things on its own.

  • One provider or a small group
  • No dedicated RCM department
  • Already using an EHR that does not catch these issues on its own

Founding partners

Use NexRev free while we build it.

NexRev is still in active development, built by people who have done revenue cycle management. Before we put a price on it, we want a small group of real practices running it on real claims, so we build what actually helps instead of guessing. That is the design-partner program: you run NexRev free or at cost, and we learn from how it performs on your claims. No cost to you, and no sales pitch from us.

1

You apply

Two minutes on the form. Tell us your EHR and how many providers you have, and that is it.

2

We set it up

We connect NexRev to your EHR with read-only access and start checking your claims. Nothing changes in how your team works.

3

You use it, we listen

Free or at cost. You tell us what is working and what is not, and that shapes what we build next.

The deal, plainly

What you get

  • NexRev free or at cost while we build
  • A direct say in what gets built next
  • Real support from the people who built it

What we ask

  • Honest feedback as you use it
  • A short case study once there's a result worth sharing
  • A couple of referrals if it's working for you

Apply to be a design partner

We use your details only to evaluate the design-partner program and to reply. No spam, and no sharing.

FAQ

Questions, answered.

Do I need to replace my EHR?

No. NexRev connects to the EHR you already use with read-only access. You keep your current system and workflow.

Do you write anything back to my EHR or submit claims for me?

No. NexRev is read-only. It checks claims and flags issues, and you and your billing team stay in control of what actually gets submitted.

Is this HIPAA compliant?

NexRev is built HIPAA-first: encryption, access controls, audit logging, and tenant isolation are designed into the architecture from the start. We are completing formal compliance documentation with independent legal review ahead of general availability, and we are glad to walk design partners through our current safeguards.

How long does setup take?

Because access is read-only and there is no migration, setup is light on your team. We will give you a realistic timeline for your specific EHR when you apply.

What does it cost?

Design partners get free or at-cost access in exchange for feedback and early data. Pricing beyond the design-partner phase is still being finalized.

Which EHRs do you work with?

We are building direct integrations starting with Athena Health and Practice Fusion, with eClinicalWorks, Elation Health, and DrChrono on the roadmap.

What specialties do you support?

We are starting with a small number of specialties during the design-partner phase and expanding from there based on what we learn.

Early Access

See what NexRev catches on your claims.

We are onboarding a handful of founding practices now. Free or at cost, with no sales pitch.

Apply to be a design partner