Find Revenue Your
RCM Platform Missed
Adjuvex audits every claim for underpayments, unreworked denials, under-coding, and Medicare Advantage RADV risk — and auto-generates the appeals to recover it.
$2.4M+
Revenue Recovered
62%
Appeal Win Rate
18 days
Avg Payback
22+ states
Payer Coverage
Your Medicare Advantage Denials Are a CMS RADV Audit Liability
Every improperly documented HCC code is a liability. Adjuvex automatically flags MA claims, cross-references CMS audit patterns, and generates a RADV-ready remediation report — before CMS finds it.
HCC Code Validation
Cross-reference every MA claim against CMS HCC mapping tables automatically.
Audit Probability Scoring
ML model predicts which claims face highest RADV scrutiny before CMS does.
RADV-Ready Reports
One-click documentation packages formatted for CMS submissions.
What We Find
7 Revenue Streams Your Platform Misses
The average health system leaves 3–7% of net revenue uncollected. Adjuvex finds it all.
Payer Underpayments
Compare paid amounts against contracted rates and flag every shortfall for recovery.
Unreworked Denials
Surface denials past timely filing thresholds and prioritize appeals by recovery value.
Under-coding Detection
NLP analysis of clinical documentation identifies services billed below their complexity level.
Unbilled Services
Cross-reference clinical notes with billed codes to find services rendered but never submitted.
Timely Filing Losses
Track payer-specific deadlines and alert staff before revenue becomes unrecoverable.
Payer Intelligence
Behavioral risk profiles — denial patterns, underpayment trends, and audit history per payer.
Medicare Advantage & RADV
The only RCM tool that cross-references MA claims against CMS HCC tables and generates RADV audit readiness reports.
The Process
From Integration to Recovery in Days
Connect Your Data
Integrate via FHIR R4, Availity clearinghouse, or CSV upload. No EHR replacement needed.
AI Audit Engine Runs
Our ML models analyze every claim across 7 revenue leakage categories within hours.
Review Findings
Prioritized dashboard shows revenue at risk, ranked by recovery probability and amount.
Recover Revenue
One-click appeal generation, RADV reports, and underpayment dispute letters ready to send.
Every Outcome Makes Adjuvex Smarter
Every appeal result trains a Bayesian win-rate engine across all customers. You get cross-industry intelligence no individual org could build alone.
Industry prior — refines with every recorded outcome
Industry prior — refines with every recorded outcome
Industry prior — refines with every recorded outcome
Industry prior — refines with every recorded outcome
Industry prior — refines with every recorded outcome
Industry prior — refines with every recorded outcome
Bayesian priors calibrated from 1,000+ published denial studies
Real win/loss data begins overriding priors. Predictions sharpen.
Cross-payer, cross-specialty intelligence no individual org could build.
Comparison
Why Adjuvex vs. the Alternatives
| Capability | Adjuvex | RI Consultant | RCM Platform |
|---|---|---|---|
| Payer underpayment detection | |||
| Unreworked denial surfacing | |||
| Under-coding AI analysis | |||
| Unbilled services detection | |||
| Payer behavioral risk profiles | |||
| MA / RADV audit risk scoring | |||
| RADV remediation reports | |||
| Real-time monitoring | |||
| FHIR API integration | |||
| SaaS (no consultant fees) |
Pricing
Transparent, Usage-Based Pricing
Most customers see ROI within 30 days. No long-term contracts.
Starter
Independent practices and small groups
- Up to 500 claims/month
- Underpayment detection
- Denial tracking
- Email alerts
- 2 users
- CSV import
Professional
Medical groups and health systems
- Unlimited claims
- All Starter features
- Under-coding AI
- RADV risk scoring
- Epic FHIR & Availity
- AI appeal generation
- 10 users
- Priority support
Enterprise
Large health systems and IDNs
- Unlimited everything
- White-label dashboard
- Dedicated CSM
- Custom EHR integrations
- SLA guarantees
- On-premise option
Ready to Find Your Hidden Revenue?
Start your free audit today. No credit card required. Results in 48 hours.