New capabilities accelerate underpayment recovery and denial appeals resolution - helping health systems recover more earned revenue as reimbursement complexity continues to grow
FRANKLIN, TN / ACCESS Newswire / April 28, 2026 / Revecore, a leading provider of complex revenue cycle management solutions for hospital systems nationwide, today announced new AI-powered capabilities across underpayment recovery and denial appeals. The announcement comes as hospitals spent nearly $18 billion in 2025 on overturning claims denials alone, according to the American Hospital Association, with no sign the pressure is easing. As health systems navigate rising denial rates, growing payer complexity, and mounting pressure on revenue cycle resources, these capabilities are designed to help clients recover more earned revenue with greater speed and consistency, building on the clinical expertise and operational discipline that have defined Revecore's approach for more than two decades.
"The reimbursement environment our clients are managing has grown steadily more complex, and the pace of that change is accelerating," said Noah Breslow, Chief Executive Officer at Revecore. "These capabilities reflect our commitment to staying ahead of those dynamics by applying AI in ways that extend what our teams already do exceptionally well and deliver stronger outcomes for clients across every dimension of the revenue cycle."
This announcement follows recent industry recognition for Revecore, including a Gold Stevie Award in the 24th Annual American Business Awards Business-to-Business Services category for its AI-powered revenue recovery intelligence platform.
AI-Driven Underpayment Recovery
Revecore is applying machine learning (ML) and intelligent automation to underpayments recovery, improving analyst yield and recovering revenue that standard approaches miss. This infrastructure, already in active use with health system clients, reflects both the technical approach and operational discipline at the core of Revecore's AI strategy.
Revecore's ML-driven prioritization models score and rank claims by recovery likelihood and expected value, ensuring that analysts are always focused on the highest-impact opportunities. A proprietary rules engine, leveraging nearly two decades' worth of underpayment experience, identifies payer-specific underpayment patterns that standard auditing approaches routinely miss. Intelligent work allocation routes accounts to the right specialist at the right time. By improving how claims are ranked and worked, these models have driven a double-digit year-over-year uplift in underpayment collections across Revecore's client base since the model's inception two years ago.
Real-time performance visibility gives hospital finance teams and revenue cycle leadership a clear view of recovery pipelines, analyst productivity, and payer trends, supporting stronger accountability and more informed decision-making.
"The investments we've made in machine learning and workflow automation for underpayments have built a deep understanding of how to apply AI effectively in the revenue cycle," said Scott Totman, Chief Technology Officer at Revecore. "Knowing where it adds the most value and how to use it to strengthen our expert teams is directly informing how we're building out our denials AI capabilities."
AI-Enabled Appeal Process Drives Higher Overturn Rates and Faster Reimbursement
Medical records can be hundreds or even thousands of pages long, making it challenging for clinical teams to extract required information for appealing denied claims. That complexity is exactly what Revecore's AI-driven medical record analysis and appeals capability is designed to solve. In conjunction with Revecore's experienced clinical and legal teams, this technology transforms how clinical evidence is identified, developed, and translated into winning arguments.
At its core is clinical evidence extraction that goes beyond summarization, applying clinical and payer-specific reasoning to parse complex medical records, align documentation to payer policy nuance, and surface the evidence most likely to overturn each denial. That intelligence flows directly into appeal generation: producing payer-specific, compliant letters informed by both the clinical evidence identified during review and patterns observed across prior appeals. The system adapts to the nuances that influence appeal outcomes, while Revecore's clinical experts apply final judgment, refinement, and submission oversight.
The result is a shift from a manual, volume-driven process to an intelligence-led recovery model that prioritizes the highest-value opportunities, improves win rates, and accelerates time to reimbursement, helping health systems more effectively counter increasingly automated payer denial strategies.
With a dramatic acceleration in their workflow, clinical experts are freed to focus where they add the most value: refining, validating, and strengthening each appeal instead of searching for basic information.
A Broader AI Strategy Focused on Long-Term Client Outcomes
The capabilities announced today are part of a long-standing, broader investment in Revecore's AI-enabled platform, built around intelligent prioritization, scaled automation, and continuous innovation across the revenue cycle. Revecore's AI is designed to complement its internal claims expertise, automating everyday processes and harnessing the power of a dataset that now exceeds 750 million claims and grows by approximately 15 million claims every month.
The result is technology that supports and scales the judgment of more than 1,000 analysts, nurse consultants, certified coders, healthcare policy specialists, and in-house legal experts, not one that works around them. As the reimbursement environment grows more complex, that combination of data, technology, and human expertise is what consistently drives better outcomes for Revecore clients.
About Revecore
Revecore is the proven leader in complex revenue cycle management, trusted by over 1,300 hospitals and health systems nationwide. Purpose-built to master revenue cycle complexity, and informed by decades of operating experience, Revecore combines AI-enabled technology platforms, proprietary claims scoring models, deep clinical and reimbursement expertise, and an outcome-aligned partnership model to deliver outsized financial impact. A six-time Best in KLAS award winner for Complex Claims Services and Gold Stevie Award recipient in the 2026 American Business Awards Business-to-Business Services category, the company has helped providers recover billions of earned revenue by resolving denials, underpayments, and complex claims at scale. For more information or to learn more about Revecore's partner program visit www.revecore.com.
Media Contact:
Elizabeth Grich
Aria Marketing for Revecore
Egrich@ariamarketing.com
SOURCE: Revecore
View the original press release on ACCESS Newswire:
https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/revecore-launches-ai-powered-underpayment-recovery-and-denial-appeals-1161486
