Rivet is a software tool that helps you optimize your team’s workflows around patient estimates, upfront patient collections, denial and underpayment appeals, and contract negotiations. With Rivet, you can identify the biggest opportunities to increase net revenue and coordinate your team’s efforts around those goals.
We’ve combined a self-serve interface with support from our internal experts to empower your team to answer patient and claim related questions, no matter your level of expertise.
Introduction to Rivet's products
Rivet has three products: Patient Pricing, Payer Performance, and Claim Resolution.
Patient Pricing
Patient Pricing is a patient cost estimator that allows you to create and send estimates to insured and uninsured patients, as well as collect patient responsibility upfront. It helps you stay compliant with the No Surprises Act and Good Faith Estimate legislation, as well as the Hospital Price Transparency Rule.
There are three tiers of Patient Pricing:
Comply (free): Designed to help you stay compliant with basic Good Faith Estimate requirements to provide cost estimates to self-pay and uninsured patients.
Estimate: Allows you to run eligibility checks, generate estimates for insured patients, and collect upfront patient payments via SMS or email.
Automate: Automatically generate estimates for your patients based on your upcoming appointments.
Payer Performance
Payer Performance helps you manage your payer contracts, model how contractual scenarios might affect future revenue, and detect and appeal claims that have been underpaid by insurance.
There are three tiers of Payer Performance:
Benchmark: Compare your contractual reimbursements to national and regional averages based on the rates insurance carriers are mandated to publish publicly.
Maximize: Manage your contracts and fee schedules, easily look up your contracted rates by procedure code, model negotiation scenarios, and optimize your billed charges to avoid lesser-of losses.
Audit: Detect and appeal claims that have been underpaid by insurance carriers.
Claim Resolution
Claim Resolution detects denials faster than your PM or EMR system, helps you prioritize what denials to work based on highest opportunity recoveries, provides on-demand insights around how to solve specific denials, and quantifies the impact you and your team are having.
There are two tiers of Claim Resolution:
Understand: Analyze your claims to quickly view month over month revenue, denial rates, and problem area trends.
Resolve: Detect and appeal claims that have been denied by insurance carriers.