Built to Identify More and Recover Faster.
The AI-powered revenue recovery intelligence platform.
About Revecore ReClaim™
ReClaim is Revecore’s AI-powered revenue recovery intelligence platform that combines advanced automation, proprietary machine learning (ML) models, AI and national payer intelligence to identify, prioritize, and recover your rightful revenue at scale.
Complex Revenue Challenges ReClaim is Built to Solve.
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Complex Claims
ReClaim manages the full lifecycle of non-standard claims (Motor Vehicle Accident / TPL, Workers' Compensation, and Veterans Affairs) from Day 1 identification through final payment reconciliation.
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Denials Management
ReClaim supports the full denial lifecycle — from automated intake and categorization through AI-assisted appeal development, payer follow-up, escalation, and cash reconciliation.
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Accounts Receivable
ReClaim underpins AR management with rule-based assignment logic and structured follow-up automation — ensuring every account is worked consistently, at the right cadence, and with the appropriate expertise.
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Underpayment Recovery
ReClaim applies thousands of proprietary identification algorithms and pricing engines to surface underpaid claims — including those that have closed at zero balance and fall outside what variance-based tools can detect.
How the ReClaim Platform Works
ReClaim Data Platform
The foundation of ReClaim is a continuously updated data asset built from cross-client payer behavior — network claims and benchmark data, payer contract and pricing data, insurance coverage intelligence, and analytics derived from hundreds of millions of annual claims across 1,300+ hospitals. This is what makes ReClaim’s detection logic smarter than anything a single institution could build on its own.
ReClaim Engine
The engine layer translates data into action. Workflow automation handles claim categorization, deadline tracking, escalation triggers, and follow-up cadence management. Client EHR interactions keep ReClaim connected to the source of record, while AI document analysis surfaces the clinical evidence that supports appeal development at a scale no manual process can match.
ReClaim Intelligence
Thousands of proprietary rules evaluate the full claim population — detecting underpayment scenarios, denial patterns, and complex claim characteristics based on payer-specific behavior, coding signals, and historical recovery outcomes. ML models predict recovery likelihood, agentic AI drives routing and orchestration, and every validated opportunity is pursued to resolution.
ReClaim Connect
ReClaim Connect automates connectivity to client EHRs and payer/government portals — enabling seamless data exchange without burdening client IT teams. Structured file transfers, EDI transactions, and portal integrations are managed within the platform, with Epic environments supported without custom development.
ReClaim Pulse
ReClaim Pulse provides 24/7 monitoring of client performance — tracking recovery trends, workflow throughput, and system health to identify issues before they affect results.
User Experience Designed for Humans and AI
ReClaim’s headless architecture means the same intelligence, automation, and data foundation powers every solution Revecore delivers, supporting both human analysts and AI agents working the same inventory, with consistent rules and shared context across every account.
Platform Capabilities
ReClaim applies over 87,000 jurisdiction-specific billing and compliance workflow rules covering state-specific, federal, and payer-specific logic for Auto/TPL, Workers' Compensation, and VA claims.
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Automated claim identification with routing to Auto, WC, or VA specialists
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Proprietary Accident Payer Search (APS) engine to identify applicable coverage within seconds
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VA Community Care billing rules, TRICARE compliance, and WC-specific EDI and attachment handling
ReClaim automates the intake and triage functions that consume clinical team capacity, and accelerates appeal development with AI-assisted record analysis.
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Automated denial categorization using payer codes and CARC/RARC logic
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Embedded payer policy libraries — MCG, InterQual, and payer-specific criteria
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AI-drafted, human reviewed, payer-specific appeal letter generation, delivering 50%+ faster drafting speed
ReClaim underpins AR management with rule-based assignment logic and AI-driven prioritization — ensuring every claim receives the right expert attention.
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Automated intake and triage, rule-based assignment logic, and AI-driven prioritization
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Structured workflow enforcement with triggered escalations and follow-up intervals
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Reporting covering liquidation performance, aging trends, and payer behavior patterns
ReClaim's underpayment infrastructure combines scale-driven identification with technology-enforced scope control aligned to client priorities.
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2,000+ proprietary rules informed by national payer behavior and historical recovery outcomes
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ML-based prioritization by recovery likelihood, financial impact, and payer behavior
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Closed-loop feedback surfaces emerging patterns before they scale, with 6–7% year-over-year uplift
What Makes ReClaim Different
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25+ Years of Proven Outcomes
Decades of specialized clinical and reimbursement expertise are hardcoded into the platform.
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Power of 1,300+ Hospitals
Benefit from collective intelligence. Our logic is sharpened by cross-client payer behavior and data from over 1,300 healthcare institutions.
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Built for What Others Miss
Every capability exists because the revenue cycle demands it — engineered for the complex claims standard tools miss.
Frequently Asked Questions
How long does ReClaim take to implement?
Revecore's solution typically takes 10-12 weeks from contract signature to fully operational, covering planning, configuration, testing, and training.
What does ReClaim need from our IT team during implementation and ongoing?
A designated program owner, IT coordination for data feeds, and access to payer portals and EMR systems. Revecore provides a dedicated Client Success Manager and operational leads.
Does ReClaim work with Epic? Oracle Health? Others?
Yes. ReClaim supports Epic, Oracle Health, and other EHRs as well as payer/government portals, enabling straight forward data exchange without burdening client IT teams.
Do we need to give Revecore access to our network or systems?
All data exchange occurs through structured, secure file transfers or HL7 and FHIR where supported by client systems.
How is ReClaim different from the workflow tools built into our EHR?
Your EHR remains the financial system of record. Revecore manages operational execution and tracking in ReClaim.
Can ReClaim handle our volume?
ReClaim processes hundreds of millions of claims annually and scales to large health systems and IDNs without degrading performance or compromising data integrity.
How does Revecore monitor platform performance?
ReClaim Pulse provides 24/7 monitoring of client performance, tracking recovery trends, workflow throughput, and system health to identify issues before they affect results.
See ReClaim In Action
Talk to a Revecore specialist about how ReClaim™ performs across your specific payer mix, claim types, and revenue cycle challenges.