Comprehensive Payments Intelligence

Going Beyond Denial Analytics

Most revenue cycle and denial reporting stops at outcomes, showing what was denied, downgraded, or written off after the fact. It doesn’t explain why revenue was lost, which decisions introduced risk, or where intervention would have changed the result.

RevProtect Payments Intelligence and Insight Reports expose the root causes of reimbursement loss—by payer, DRG, and clinical context—so leaders can see where revenue is leaking and take action.

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AI-Driven Revenue Cycle Insights

Payer intelligence, not just denial reporting

RevProtect reverse-engineers each payer’s adjudication logic by analyzing their payment patterns. This payer intelligence goes beyond surface-level categories to uncover the specific rules, edits, thresholds, and policies each payer applies.

RevProtect reveals

• How different payers interpret similar clinical scenarios
• Where documentation or coding decisions consistently trigger denial risk
• Which DRGs are most exposed to payer-specific behavior

Pinpoint the Root Causes of Reimbursement Risk

RevProtect provides detailed visibility into reimbursement performance across the full denial and payment lifecycle.

Administrative Denials

CARC and RARC denials analyzed by type, root cause, and payer

Clinical validation and DRG risk

Medical necessity denials, DRG downgrades, and payer-specific validation patterns

Payment confidence by payer and DRG

Baseline scoring to quantify expected reimbursement risk across payer-DRG combinations

Coding behavior and resequencing patterns

Identification of payer-driven coding shifts and downgrade trends

Disputes, appeals, and overturn rates

Appeal outcomes analyzed by payer to surface true overturnability and recovery potential

Recoupments and write-offs

Takebacks and final write-offs analyzed to expose downstream revenue leakage

By establishing a clear, data-driven view of payer behavior and reimbursement risk, health systems armed with RevProtect are equipped to proactively prevent denials and other adverse payment outcomes.

RevProtect intelligence powers:

• Adverse payment outcome predictions
• Actionable recommendations that guide prevention and recovery
• Validation and learning that measures impact and continuously improves performance

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Real, Impactful Savings Start with a Denials Insights Report

The RevProtect Denials Insights Report delivers a comprehensive analysis of your organization’s denial trends, adverse payment outcome patterns, and payer-specific intelligence.

The Insights Report includes:

• Detailed breakdown of reimbursement risk by payer, DRG, and denial type
• Identification of high-risk service lines and clinical areas
• Payer-specific adjudication pattern analysis
• Quantification of revenue at risk and underpayment exposure
• Strategic recommendations for documentation and workflow improvements

The Insights Report provides actionable intelligence to inform UR, CDI, Coding, and PFS strategy—and helps prioritize where revenue cycle efforts will have the greatest impact.

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Aligned to Outcomes, Not Promises

RevProtect is available through a performance-based engagement model designed to align incentives and reduce risk. Sift partners directly with health systems to tie success to measured reductions in denials and adverse payment outcomes (not activity, licenses, or usage).

Talk with us about whether a performance-based model makes sense for your organization.

Justin Nicols

Founder & CEO

A leading industry expert in data analytics technology and has an extensive background in corporate finance and investment banking. Prior to founding Sift, Justin served on the executive team of a venture-backed ad technology company and an e-commerce technology company.