Question 1

What does 'zero financial risk' mean for our organization?

Accepted Answer

Our performance-based pricing model means you only pay when we successfully recover underpaid claims. There are no upfront costs, no subscription fees, and no implementation charges. If we don't find and recover underpayments, you pay nothing. This eliminates financial risk while ensuring our incentives are aligned with your revenue recovery goals.

Question 2

How does Medlyze work alongside our existing RCM systems?

Accepted Answer

Medlyze acts as a forensic quality control layer that complements your existing RCM tools, clearinghouses, and billing systems. We don't replace your workflows, we enhance them by analyzing aged claims (12-24 months) and closed accounts that are no longer being actively worked. Think of us as forensic auditors who catch what slips through your primary processes. Zero disruption, pure upside.

Question 3

Why are underpayments becoming more common?

Accepted Answer

Payers are using increasingly complex reimbursement methodologies, multiple fee schedules per contract, and aggressive bundling logic that often results in underpayments. Many of these go unnoticed because they're processed as 'paid' claims, not denials. Our contract-to-payment validation automatically catches these discrepancies before they become permanent revenue leakage.

Question 4

What makes Medlyze different from traditional recovery firms?

Accepted Answer

Traditional recovery firms rely on manual audits that take 6-12 weeks and only sample 5-10% of claims. Medlyze uses automation to analyze 100% of your claims in 2 weeks, with continuous monitoring for new underpayments. We integrate with your RCM workflows for ongoing compliance, not just one-time recoveries. And we offer the same zero-risk, performance-based pricing, just faster and more comprehensive results.

Question 5

How far back can Medlyze analyze claims for underpayments?

Accepted Answer

We perform forensic analysis of aged claims going back 12-24 months, focusing on claims that are no longer being actively worked by your team. This includes paid claims with incorrect fee schedules, bundling errors, modifier issues, and outlier claims. We prioritize recoveries by ROI so you focus on the highest-value opportunities first.

Question 6

How does Medlyze help RCM teams recover underpayments?

Accepted Answer

Our Revenue Integrity platform automatically detects underpayments by matching contract terms to actual payments. We identify variances, quantify underpayments, and prioritize recoveries by ROI, helping teams recover cash faster while saving 20+ hours per week on manual audits.

Question 7

Can Medlyze automate our appeals process?

Accepted Answer

Yes! Our platform generates standardized appeals packages with contract documentation, payment analysis, and supporting data. This automation reduces manual work by 70% and accelerates the appeals process from weeks to days.

Question 8

How does contract-to-payment matching work?

Accepted Answer

We compare actual claim payments to contracted rates in your payer agreements. When payments fall short of contract terms, our platform flags the variance, quantifies the underpayment, and provides documentation for appeals, all automatically.

Question 9

Can we use Medlyze with multiple providers or facilities?

Accepted Answer

Yes! Our platform supports multi-facility RCM operations. Manage contract compliance, underpayment detection, and appeals tracking across all your provider clients or facilities from a single dashboard.

Question 10

How long does implementation take for RCM teams?

Accepted Answer

Implementation typically takes 1-2 weeks. This includes contract data upload, payer configuration, integration with your billing system (if needed), team training, and validation. Most teams start identifying underpayments within the first month.

Question 11

Do you integrate with our practice management or billing system?

Accepted Answer

Yes! We integrate with major PM/billing systems including Epic, Cerner, Athenahealth, eClinicalWorks, and others. We can also work with your IT team on custom integrations or accept data exports in standard formats.

Question 12

What kind of ROI can RCM teams expect?

Accepted Answer

RCM teams typically recover 2-4% of net revenue through underpayment detection. For a hospital with $100M in net revenue, that's $2-4M in recovered cash. Additional benefits include 20+ hours saved per week on manual audits, faster appeals processing, and improved cash flow from proactive contract compliance monitoring.

Question 13

What support do you provide for RCM teams?

Accepted Answer

We provide dedicated account management, technical support, training for your team, quarterly business reviews, custom analysis for complex contract issues, and ongoing support for appeals and recovery efforts.

Recover Lost Revenue — With Zero Financial Risk

Why Revenue Cycle Management Teams Choose Medlyze

Solutions for Revenue Cycle Management Teams

Free Resources for Revenue Cycle Management Teams

Learn More: Free Implementation Guides

Medical Bill Review Best Practices

Payer Contract Negotiation Guide

Blue Cross Blue Shield Price Transparency

The State of Commercial Reimbursement: Q3 2026

What Our Clients Say

Frequently Asked Questions

Ready to Maximize Revenue, Reduce Costs, and Save Time?