For Labs, Specialty Practices & Value-Based Care
Ardia Health's AI engine reasons about clinical documentation to recover lost and wrongfully denied revenue — not just flagging errors, but explaining exactly why revenue was denied and generating evidence-backed recovery arguments.
Biomarkers: EGFR L858R mutation, PD-L1 75%
Recommendation: Osimertinib + Pembrolizumab combo
Payer: Medicare Advantage · Palmetto GBA
Denial: CO-50 Medical Necessity Not Established
Amount at Risk: $127.50
We're not a billing software. We're not an alert system. We're a clinical reasoning engine that understands payer logic from the inside.
Our engine reads clinical documentation, cross-references payer-specific LCD rules, and generates a mechanistic explanation for every denial — then builds the evidence-backed recovery argument.
12+ years at Cigna, UnitedHealth, Optum, and Teladoc. We know exactly how denial logic is constructed from the inside — giving us a unique advantage in defeating it.
We earn 15–20% of recovered revenue only when you succeed. No upfront cost. No implementation fees. ROI is visible within 30 days of deployment.
Manual appeals cost $118 and succeed 45% of the time. Ardia costs $2.50 and succeeds at 68–89% — a 47× cost reduction at nearly double the success rate.
The only platform combining genomic intelligence with reimbursement intelligence. We make precision medicine economically sustainable — MolDX, Z-codes, and 400+ PLA codes.
HIPAA-compliant from day one. AppExchange distribution to 150,000+ healthcare organizations. 60–70% faster development with 12 Salesforce certifications.
The RCM space is crowded with alerting tools, billing software, and generic AI. Ardia is the only platform that reasons, argues, and proves — built by people who designed the denial systems it defeats.
| Capability | Quest / LabCorp RCM | Generic AI (Olive, Waystar) | Traditional RCM Vendors | ⚡ Ardia Health |
|---|---|---|---|---|
| Clinical Reasoning (not just flagging) | ✗ | ✗ | ✗ | ✓ |
| Lab-Specific Denial Logic (LCD/NCD) | ⚠ Partial |
✗ | ✗ | ✓ |
| Auto-Generated Appeal Narratives | ✗ | ⚠ Generic only |
✗ | ✓ |
| Pharmacogenomics + MolDX Reimbursement | ✗ | ✗ | ✗ | ✓ |
| Zero-Risk Contingency Pricing | ✗ | ✗ | ⚠ Rare |
✓ |
| TX SB 1188 + TRAIGA Compliant by Design | ✗ | ✗ | ✗ | ✓ |
| Built by Former Payer Insiders (Cigna/UHC) | ✗ | ✗ | ✗ | ✓ |
Six automated steps. No manual review. No template letters. Clinical reasoning powered by AI at every stage — from raw denial data to payer-formatted appeal in under 90 seconds.
The AI in RCM market grows at 24% CAGR. Independent labs are completely unserved.
Interactive dashboard showing real-time denial analysis, MAC LCD cross-reference, and recovery narrative generation.