AI-Driven Payments Intelligence | Sift Healthcare
Predictable Reimbursement. Protected Revenue.
Payer rules are constantly changing. RevProtect applies advanced AI to ensure health systems capture every dollar they’ve earned.
Prevent Revenue Loss
RevProtect delivers payment intelligence that predicts, prevents, and resolves reimbursement risk for health systems turning clinical and payments data into next-best actions across UR, CDI, Coding, and PFS.
Why Reimbursement Has Become Harder
- Payers use AI to scrutinize documentation and downgrade claims, including retrospective audits on claims that were paid 12+ months ago
- Revenue loss now happens through various adverse payment outcomes: level-of-care downgrades, denials, clinical validation or DRG reductions, and takebacks
- Revenue risk is introduced before billing, not just at denial
- Teams are understaffed and overworked
RevProtect addresses these challenges through four integrated capabilities:
Comprehensive Intelligence RevProtect connects clinical data to real payment outcomes, exposing where revenue risk is introduced — by payer, DRG, service line, and process.
Real-time Reimbursement Prediction RevProtect predicts reimbursement risk as care is documented, modeling underpayments, DRG downgrades, and clinical takeback probability in pre-bill, not weeks after the claim is submitted.
Actionable Prevention & Recovery RevProtect turns reimbursement risk into clear, role-specific recommendations and actions, embedded directly into revenue cycle workflows.
Validation & Learning RevProtect continuously refines data models, predictions, recommendations, and updates ROI metrics.
RevProtect makes reimbursement predictable and adverse payment outcomes preventable — before claims go out the door.
Real, Impactful Savings.
For a representative $1B health system:
- Annual denial reduction opportunity: $22M
- In protected revenue for every 0.1% reduction in denial rate: ~$1M
- ROI for denial prevention: 5x
Enterprise-Grade Data Foundation
- 10,000+ data points analyzed across the full claims lifecycle
- 329 Proprietary MS-DRG playbooks powering actionability
- 692 normalized clinical + financial data elements
- 88 real-world adoptions of Sift intelligence deployed across health systems
How Health Systems Deploy RevProtect
RevProtect is designed to fit into existing revenue cycle workflows, reducing portal friction, improving adoption, and making lift measurable from day one. Choose the deployment path that matches your environment:
Use Sift’s UI
Get value fast with a purpose-built experience for denials, overturnability, and prevention workflows.
Embed in existing tools (EHR or third-party)
Bring predictions, recommendations, and rationale directly into the worklists and queues teams already live in, with adoption and throughput lift tracked at the user and workflow level.
Work through a partner
Deploy through one of Sift’s strategic partners to accelerate integration and scale across your footprint.
Real-World Results
2025 Annual Denials Insights Report
Driving Denial Reduction And Revenue Recovery Improvement
Tracking & Preventing Adverse Payment Outcomes
Harnessing The Power Of AI
*Illustrative; varies by payer mix, denial rates, and workflow adoption.
Sift Intelligence
- Claim Denials, Denials, Healthcare Payments, Revenue Cycle Analytics
Hidden Denials Your Reports Miss: Aetna Medicare Underpayments
- AI in the Revenue Cycle, AI Works
Marketing View: The Best AI in Your Revenue Cycle Should Be Invisible
- Healthcare Payments, Revenue Cycle Analytics, Sift CEO Perspectives
CEO Perspectives: Hospitals Think They’re Maximizing Revenue. They’re Only Measuring Half Of It.
- Denials, Revenue Cycle Analytics
What Your BI Or Analyst Team Can Tell You About Denials, and What It Can’t
- Denials
Top 8 Denials Management Metrics Every Hospital Should Track
- Claim Denials
7 Claims Lifecycle Gaps Slowing Hospital Cash Flow
- Claim Denials, Denials
Prioritizing Denials: How to Find the Recoverable Dollars in Your Denial Workqueue
- Claim Denials, Denials
Which Hospital Denial Tools Provide Payer-Specific Denial Intelligence? What to Actually Look For.
- Claim Denials, Denials
AI Denial Prevention: Your Model Flagged a Denial. Now What?
Get in Touch
Prevent costly denials while making your CDI, coding, and UR workflows more efficient and connected.
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.