Rialtic Edits
Rialtic Edits is a cloud-native claims editing platform that helps health plans prevent payment errors before they happen. Combining an expert-curated policy library with real-time, automated editing and complete transparency, Rialtic gives your team control over every aspect of payment accuracy.
Talk to Us →Industry-sourced payment policies built and maintained by experts, continuously updated to reflect evolving regulations and payer requirements.
Payment policies for Medicaid, Medicare, and commercial plans
National and regional coverage determinations, including NCDs, LCDs/LCAs
Institutional and outpatient edits across CMS-1500, UB-04, and DME — cross-claim, code mapping, bundled, and ASC
Drug edits for FDA and off-label use across diagnosis, age, units, and frequency
Replace black-box editing with complete visibility into every payment decision. Every policy and denial is explainable, traceable, and backed by source documentation.
Every policy and denial linked to source documents and supporting excerpts
Human-readable explanations for every edit and claim recommendation
Complete version history and audit trail for every policy
Rich metadata and transparent decision logic that simplify provider inquiries, investigations, and audits
Take ownership of your payment policies throughout their lifecycle. Preview, customize, validate, activate, and maintain policies with complete control, while understanding the impact of every change before it goes live.
Rialtic's Payment Accuracy System is
HITRUST CSF r2 certified. SOC 2® Type II compliant.
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Discover how we can help transform your payment accuracy processes with advanced claims editing platform, seamless customization, and efficiency.
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