Reduce medical spend and administrative waste with Payer Super Agents

Increase speed, accuracy, and transparency across payment decisions with human supervision

Super Agents for payment accuracy decisions

Activate anywhere across the pre-pay and post-pay claim lifecycle to drive faster, policy-aligned
decisions that improve payment accuracy and efficiency

Rialtic Pre - Payment Accuracy Suite

From claim intake to final payment — agents that apply coding, billing, and policy expertise to maximize accuracy, lower medical spend and reduce administrative costs.

REDUCE MEDICAL SPEND

LOWER ADMINISTRATIVE BURDEN

ACCELERATE PROCESSING TIME

SUPER AGENTS

Rialtic Edits

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale.
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*Currently available as Rialtic Payment Integrity Platform

Rialtic CCAR (Claims Coding Accuracy Review)

Reviews and validates complex claim coding against clinical documentation, coding guidelines, and payer policies— generating cited determinations with human-in-the-loop review.

Rialtic Dupe (Duplicate Claims)

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic L2D (Likely to Deny)

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic COB (Coordination of Benefits)

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic Argentis (Claims Anomaly Detection)

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic HDC (High Dollar Claims)

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic Pends

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic Prior Authorization Suite

Agents that carry each request from intake through eligibility, medical necessity and coverage determination — returning fast, consistent, policy-aligned recommendations, with human-in-the-loop validation.

Greater accuracy in policy application

Faster PA approvals at lower cost

CMS-0057 compliance

SUPER AGENTS

Rialtic Payer Auth

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic Audit and Appeals Suite

From dispute to resolution — agents that conduct audits, manage appeals, and deliver evidence-backed decisions.

REDUCE ADMINISTRATIVE BURDEN

IMPROVE TURNAROUND

SUPER AGENTS

Rialtic Audit

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Rialtic Appeals

Combines claims, policy intelligence, and advanced edit logic to identify payment inaccuracies before claims are paid. Applies publicly sourced and client-specific policies to drive consistent, defensible decisions and reduce payment leakage at scale. 

Take control of your payment accuracy with Rialtic