Pre-billing order checks for labs

Fix the order. Not the denial.

Every denial started as an order somebody could still have fixed. Revenue Guard checks each one against your payer rules before billing — while it is an edit, not an appeal.

Start free trialRead the API docs

How it works

Your rules. Every order. Before billing.

Start with what your billing team already knows — write the rules straight in. Have the payer’s policy document? AI reads it and drafts rules from it too. Nothing goes live until your team promotes it — after that, a correction that only narrows a rule can apply itself once it has been checked against your own recent orders. It never widens what a rule catches.

The leak

By the time billing sees it, the damage is done.

The order goes out. The claim goes out. Six weeks later the denial arrives — and now it is an appeal, a rework, or a write-off, for something that was a thirty-second edit at order entry.

~15%

of private-payer claims denied on first submission

~70%

of denials eventually overturned and paid

$25.7B

spent adjudicating claims that year

Premier Inc. — 280 hospitals, 23 states, 2023 claims. Hospital figures, not lab. Not ours.

Provenance

A rule from a document cites the line it came from.

Where AI drafted a rule, it never asks you to take its word for it — click through to the exact sentence, verified against the page before it was stored. Rules your team wrote say so plainly instead.

The signals

Three signals. One clear decision.

AI checks each order against the rules your team promoted. Every finding comes back graded — Critical, Warning, or Info — with the rule that fired, why it fired, and the fix.

It grades. It never scores. Your team knows what to fix now and what can wait.

The demo

Watch it in action.

Integration

Nothing changes for your team.

Orders reach Revenue Guard from whatever you already run — LIMS, EHR, referral pipelines — over a single endpoint your systems team points at once. Nobody changes how they book an order, and no one logs into a second system to work a queue.

  • Send from any sourceLIMS, EHR, RIS, referral pipelines — if it can POST JSON, it can send orders.
  • Only the essentialsDemographics, insurance, tests, ICD and CPT. No full chart, no heavy integration.
  • Signed webhooksHMAC-SHA256 with secret rotation. Sandbox and live never touch.
Read the API docs →
POST /public/v1/orders
# an order, from any source
{
  "order_id": "ORD-10428",
  "payer_ids": ["b7c1e0a2-..."],
  "patient_info": {
    "patient_uid": "PT-5512",
    "dob": "1962-03-11",
    "sex": "F"
  },
  "insurance_info": {
    "insurance_name": "Example Health Plan",
    "policy_number": "..."
  },
  "ordered_tests": [
    {
      "short_name": "HbA1c",
      "test_name": "Hemoglobin A1c",
      "test_code": "GLU-A1C",
      "cpt_codes": ["83036"],
      "icd_codes": ["E11.9"]
    }
  ]
}

→ 200
{
  "orderId": "ord_9fQ2xK...",
  "externalOrderId": "ORD-10428",
  "version": 1,
  "status": "created",
  "environment": "sandbox"
}
  • Every order, checked against your payer rules — before billing.
  • Runs alongside your eligibility and prior-auth systems.
  • Nothing to rip out — your LIS and billing stack stay exactly as they are.

A signed BAA, 30-day document retention, and a named reviewer on every flagged order.

Pricing

One price. Every order.

$500/ month

14 days free, no card. Nothing is charged unless you choose to continue.

  • Every order checked — no per-order fee, no usage limit.
  • Unlimited people. Nobody pays per seat.
  • API access, webhooks and recommendations included.

Start today

Point it at the payer you argue with most.

Fourteen days, no card. Start with a single payer — the one your team argues with most — and see what it catches on orders you have already sent.

Start free trial

Book a walkthrough

We’ll come back to you to fix a time. No patient data — this form is for contact details only.

No integration yet?

Paper becomes orders. Also with AI.

Faxed, scanned, handwritten — AiReq reads the requisition and turns it into a structured order your team approves. Same idea as Revenue Guard, pointed at the requisition instead of the order. Those orders are exactly what Revenue Guard then checks.

See how AiReq works →