Cost
Labor capacity
Today
- Evidence researched by hand
- Research spread across disconnected sources
- Complex appeals require manual drafting
With Lumivera
- Auto-assembled evidence packages
- Appeal evidence in minutes, not hours. No write-off threshold.
For Finance Leaders
Know what every insurer owed on the day of care. Then collect it.
Payment intelligence brings contracts, utilization, revenue cycle and finance into one record. Payment variance on every remittance line, rolled up to net revenue and contractual allowance. Policy change net revenue impact on day one.
Direct answer
What is Autonomous Revenue Defense?
Autonomous Revenue Defense is Lumivera's operating model for protecting payer revenue. A Temporal Knowledge Graph holds every contract, policy and regulation as it stood on the date of service.
Agents on frontier models enforce those rules against every claim before it leaves and every payment after it lands. The finance team sees the variance, the proof and the recovery in one record.
Autonomous Revenue Defense
CFO operating view
Payer shift detection
Day one
Policy change net revenue impact on day one.
CostAppeal evidence in minutes, not hours.
ControlPolicy change net revenue impact on day one.
CashFound, pursued, recovered: every dollar tracked from detection to cash.
Core-system migrationNot required
The CFO’s three greatest constraints
Lower the cost of defense. Restore control. Accelerate cash.
Autonomous Revenue Defense changes the operating model behind payer revenue - not just the dashboard used to report it.
Control
Predictability
Today
- Payer shifts detected after financial variance
- Denials left without assembled evidence
- Performance explained after the financial impact
With Lumivera
- Policy change net revenue impact on day one.
- Denials and underpayments surfaced for defense
- Weekly performance-versus-expectations reporting
Cash
Financial yield and velocity
Today
- Earned revenue expires inside filing and appeal windows
- Asymmetric intelligence in contract negotiations
With Lumivera
- Found, pursued, recovered: every dollar tracked from detection to cash.
- Faster recovery with the correct historical evidence
- Violation evidence packets for stronger contract terms
Replace delayed, manual defense with an autonomous operating model
Finance leaders do not need another reporting layer. They need the capacity to defend earned revenue at payer speed, explain performance against expectations, and convert every violation into negotiating pressure.
Scroll sideways to compare Today with Lumivera.
| Today | With Lumivera | |
|---|---|---|
| Labor capacity | Manual evidence assembly limits capacity | Appeal evidence in minutes, not hours. |
| Complex appeals | Manual research and drafting | Appeal evidence in minutes, not hours. |
| Evidence research | Manual research across disconnected sources | Unified source of truth with the correct historical evidence |
| Denials and underpayments | Revenue is written off below the attention threshold | No write-off threshold. Agents assemble evidence for every variance. |
| Payer shifts | Changes detected after financial variance appears | Policy change net revenue impact on day one. |
| Negotiation intelligence | Asymmetric payer advantage | Evidence packet of violations, impact, and contract context |
The autonomous revenue-defense loop
Detect the shift. Assemble the evidence. Defend the cash. Strengthen the next deal.
01
Detect
See payer policy changes on day one, with the net revenue effect.
Monitor payer policies, contract terms, claims, denials, and underpayments continuously instead of waiting for downstream financial variance.
02
Assemble
Turn weeks of research into hours.
Search the unified source of truth, use Time Travel to retrieve the correct historical evidence, and auto-assemble complex appeal support across the relevant sources.
03
Defend
Hold payers accountable at scale.
Give analysts the evidence and context to act on every denial and underpayment worth pursuing, without rebuilding the case by hand.
04
Negotiate.
Convert documented violations into negotiating power.
Package recurring payer behavior, financial impact, and contract evidence for renewal strategy and more favorable terms.
Autonomous Revenue Defense for the CFO agenda
Increase financial yield and velocity while giving leadership tighter control over payer performance, labor capacity, and operating-margin exposure.
Found, pursued, recovered.
Every underpayment, denial and recoupment is tracked from detection to cash, whether your team or your recovery partner works it. You see dollars found, dollars pursued and dollars recovered, by payer and by month.
No Write-Off Threshold: Agents Work Every Dollar.
Agents assemble the evidence for every short pay, including the ones below the line your team cannot reach. The thousand small cuts are worked, not written off. Up to 65% of denied claims are never resubmitted.
SOURCES: HFMA, Strategies for Proactive Denial Management and Prevention (2018, updated 2025)
Policy change net revenue impact on day one.
When a payer changes a policy, you see which claims it touches and what it does to net revenue, the day it takes effect.
Time Travel with forensic accuracy.
Search one unified source of truth for the contract, the policy and the claim as they stood on the date of service, with every version kept. The rule you cite is the rule that applied.
Manage to expectations
Weekly performance against expectations, where expected payment is computed from the contract in force on the date of service, not the contract as loaded today.
Negotiate from documented violations
Bring an evidence packet of recurring payer violations and financial impact into negotiations to support stronger contract terms.
Payment integrity, for the side that is owed.
Insurers run prepay and postpay payment integrity against every claim.
Cotiviti earns an estimated $1.5B to $2.0B a year applying contract terms to claims for the 25 largest insurers, at 15 to 18 cents of each dollar.
SOURCES: Cotiviti Form 10-K (2017) • Moody's rating action on Cotiviti term loan (2024) • KKR recapitalization press release (2024)
Lumivera runs the same check for the hospital: before the claim leaves and after the payment lands.
Pre-Submission Payment Integrity and Post-Remittance Payment Integrity, against the rule in force on the date of service.
No transformation program. No migration.
Lumivera reads Epic, Oracle Health, Workday, Oracle Cloud EPM, Strata, your clearinghouse and your warehouse in place, and adds Autonomous Revenue Defense around them. Nothing is replaced.
Common questions
Autonomous Revenue Defense, explained
What is Autonomous Revenue Defense?
Autonomous Revenue Defense is Lumivera’s provider-side operating model for detecting payer changes, assembling historical evidence, defending denials and underpayments, and carrying recurring violations into contract negotiations. It connects payer contracts, policies, claims, payment, and time-sensitive context.
Why is Autonomous Revenue Defense a CFO priority?
Hospitals spent $43B in 2025 to collect money insurers already owed.
SOURCES: AHA, Costs of Caring (2026)
2,300 hospitals still lost $48B to final denials and bad debt.
SOURCES: Kodiak Solutions, State of the Healthcare Revenue Cycle (2026)
The margin is gone. What is left is the money insurers already owe.
How does Lumivera increase appeal capacity?
Agents assemble the appeal evidence packet, clause, policy version, remit line and market rate, in minutes, not hours, for every variance, including those below the write-off threshold. Your team or your recovery partner files it.
How does Lumivera detect payer changes?
Lumivera preserves payer-policy and contract context across time and monitors changes as they occur. Finance and operating teams see policy change net revenue impact on day one, rather than waiting for downstream variance.
How does revenue defense strengthen payer negotiations?
Lumivera assembles an evidence packet of recurring payer violations, affected claims, financial impact, and the governing contract or policy context. Managed care and finance leaders can use that record to support more favorable terms and clearer accountability.
Does Lumivera replace ERP, FP&A, or RCM systems?
No. Lumivera reads them in place. Epic, Oracle Health, Workday, Oracle Cloud EPM, Strata and your clearinghouse stay where they are.
Connect the CFO agenda to the product layer
Move from a finished negotiating position to living rules, enforcement on every claim and payment, and a clearly labeled roadmap.
Bring finance a finished negotiating position with confidence-graded exhibits
Rate Intelligence ReportsTurn payer agreements into living rules, as they stood on any date of service.
Contract IntelligenceSee the roadmap: autonomous surveillance across the revenue cycle.
Payment Intelligence roadmapPut Autonomous Revenue Defense on the CFO agenda
Bring the payer, contract, recovery, or performance question your team is trying to explain. We’ll show you the current product path and clearly separate it from future roadmap capabilities.
Request a demo