Find the Revenue Your RCM Platform Missed
Adjuvex uses AI to surface underpayments, unreworked denials, under-coded claims, and Medicare Advantage RADV audit risks that traditional RCM tools leave on the table.
$2.4M+
Revenue Recovered
62%
Avg Appeal Win Rate
18 days
Avg Payback Period
22+ states
Payer Coverage
Your Medicare Advantage Denials Are a CMS RADV Audit Liability
Unique to AdjuvexCMS Risk Adjustment Data Validation (RADV) audits can claw back millions from MA plans and their providers. Every improperly documented HCC code is a liability. Adjuvex automatically flags MA claims with HCC risk, cross-references CMS audit patterns, and generates a RADV-ready remediation report — before CMS finds it first.
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HCC Code Validation
Cross-reference every MA claim against CMS HCC mapping tables
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Audit Probability Scoring
ML model predicts which claims face highest RADV scrutiny
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RADV-Ready Reports
One-click documentation packages formatted for CMS submissions
What We Find
7 Revenue Streams Your Current Platform Misses
The average health system leaves 3–7% of net revenue uncollected. Adjuvex finds it all.
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Payer Underpayments
Automatically compare paid amounts against contracted rates and flag every shortfall for recovery.
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Unreworked Denials
Surface denials past timely filing thresholds and prioritize appeals by expected recovery value.
📝
Under-coding Detection
NLP-powered analysis of clinical documentation identifies services billed below their complexity level.
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Unbilled Services
Cross-reference clinical notes with billed codes to identify services rendered but never submitted.
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Timely Filing Losses
Track payer-specific filing deadlines and alert staff before revenue becomes unrecoverable.
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Payer Intelligence
Behavioral risk profiles for each payer — denial patterns, underpayment trends, and audit history.
⚠️
Medicare Advantage & RADV Risk
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, Availity clearinghouse, or CSV upload. No EHR replacement required.
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 recorded — across every customer — trains a Bayesian win-rate engine. You get cross-industry intelligence on which arguments win against which payers. No competitor has this.
Industry prior — grows more accurate with each recorded outcome
Industry prior — grows more accurate with each recorded outcome
Industry prior — grows more accurate with each recorded outcome
Industry prior — grows more accurate with each recorded outcome
Industry prior — grows more accurate with each recorded outcome
Industry prior — grows more accurate with each 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 | |||
| API / FHIR integration | |||
| SaaS (no consultant fees) |
Pricing
Transparent, Usage-Based Pricing
Most customers see ROI within 30 days. No long-term contracts.
Starter
For independent practices and small groups
- Up to 500 claims/month
- Payer underpayment detection
- Denial tracking
- Email alerts
- 2 users
- CSV data import
Professional
For medical groups and health systems
- Up to 2,500 claims/month
- All Starter features
- Under-coding AI detection
- RADV risk scoring
- Epic FHIR & Availity integration
- 10 users
- Priority support
Enterprise
For large health systems and IDNs
- Unlimited claims
- All Professional features
- 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.