Revenue intelligence · not included with Essentials
In developmentReQover is a separate revenue-intelligence track — not part of OpAgent Essentials and not the complete financial intelligence plane. Claim Radar is always-on sensing. ReQover is the staff workflow that consumes it. Detection is not recovery. Contract and payment connectivity is not claimed as complete.
Always-on sensing
Remittances read against the contracts you signed. Underpayments, downcodes, and denials worth looking at — infrastructure, not a staff worklist by itself.
Staff-facing workflow
The queue that consumes Claim Radar plus economic truth. Flags, evidence, and a decision: appeal, educate, or let it go. The ReQover name stays on the work.
The moment it solves
A payment that looks fine against a national benchmark can still be short against the rate this practice negotiated. Detection recall is a sensing metric. It is not a recovery rate, and this study is not a payer leaderboard.
How it works
Always-on. Contract-aware. Not a nightly export someone has to remember to run.
Appealable work versus documentation/education. Not every flag is cash.
ReQover does not promise recoveries and does not guarantee savings.
Evidence of value
MEASURED PERFORMANCE
Tag-path recall on the downcode-detection review log
91 / 93 review-log rows detected; effective 91 / 92 valid rows. Do not imply every flagged underpayment is recoverable.
OpAgent Benchmark: downcode-detection tag-path recall on the review log.
Sample: 91 / 93 review-log rows · 91 / 92 valid rows
Detection is not recovery. Do not create payer leaderboards from this study.
Source: OpAgent Benchmark
MEASURED PERFORMANCE
Queue split: appealable vs documentation/education
46 appealable · 47 documentation/education. Not every flagged underpayment is recoverable.
OpAgent Benchmark: staff queue split from the downcode-detection study.
Sample: 93 review-log rows
A queue split is not a recovery rate.
Source: OpAgent Benchmark
Tag-path recall is a detection metric on the downcode-detection review log. Do not imply every flagged underpayment is recoverable. Do not publish payer leaderboards from this study.
OpAgent Benchmark · Claim Radar / ReQover · detection ≠ recovery
Where it connects
The understanding layer that keeps working after the encounter.
Declared policy, kept separate from what the remittance actually did.
The visit coding that should have been supportable before the claim left.