Pediatric Therapy Revenue Intelligence

Revenue intelligence command system
for pediatric therapy.

Griffin RevCore helps pediatric OT, Speech, and PT clinics identify revenue at risk, isolate denial root causes, organize evidence, generate payer-facing recovery actions, and track outcomes from one operational command center.

Request Workflow Review See the Difference
Built around real denial workflows
Revenue at risk visibility
Outcome-focused pilots
Griffin RevCore · Mission Control
CASE-0084 · Revenue At Risk
Strategy Locked Appeal Ready
$4,250
Recovery Command · CPT 97760 · BCBS
Root cause identified: payer determination requires structured clinical support and denial-specific evidence review.

Next action: generate payer-facing appeal, attach supporting records, track follow-up, and record recovery outcome in Mission Control.
$ At risk
8+ Recovery lanes
Live Outcome tracking
Medical Necessity · Authorization Mismatch · Timely Filing · CO16 / M76 Corrected Claims · PR96 / N569 Diagnosis Coverage · Overpayment Recoupment · Expired Referral · Bundling Disputes · Medical Necessity · Authorization Mismatch · Timely Filing · CO16 / M76 Corrected Claims · PR96 / N569 Diagnosis Coverage · Overpayment Recoupment · Expired Referral · Bundling Disputes ·
Revenue Friction

The denial is visible.
The investigation cost is hidden.

Pediatric therapy clinics lose time before recovery work even begins: finding the denial basis, locating authorization history, gathering evidence, reconstructing payer communication, and deciding what action comes next.

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Investigation slows recovery

Before a case can be appealed, teams often have to reconstruct what happened, who touched it, which payer rule applied, and what evidence is missing.

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Generic tools stop too early

EHRs and billing systems may show the claim status, but they rarely convert the denial into a clear recovery strategy, evidence checklist, and outcome trail.

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Lessons disappear in queues

The same payer behavior and workflow breakdowns repeat because the knowledge stays trapped in individual claims, spreadsheets, portals, and staff memory.

Auth Authorization, referral, unit, CPT, and provider mismatches create investigative work before recovery starts
Code CO16, M76, diagnosis, and corrected-claim issues need clean routing before anyone writes an appeal
Med Medical necessity denials require evidence structure, functional context, and payer-facing review posture
Track Every case should connect to root cause, next action, owner, deadline, outcome, and recovered revenue
See the Difference

Generic follow-up vs.
recovery intelligence.

Many denial workflows start with manual interpretation. Griffin RevCore turns each case into a classified recovery path with the right evidence, action, and payer-facing documentation.

Standard Appeal

Dear Payer,

We are requesting reconsideration of the denial for the above-referenced claim. The services provided were medically necessary and appropriate for this patient.

Please review the attached documentation and reconsider this claim for payment.

Thank you for your time and consideration.

No specific criterion challenged. Low overturn probability.
Griffin RevCore Output

Dear Blue Cross Blue Shield,

The submitted documentation reflects measurable therapeutic progression, continued skilled treatment involvement, and ongoing functional communication deficits requiring active intervention.

The current determination does not appear to address the documented progression, therapeutic response, or ongoing skilled treatment requirements reflected in the submitted record.

Please review the attached documentation and reconsider the claim based on the submitted clinical findings, plan of care, and documented functional response to therapy.

Specific clinical findings challenged with structured payer-facing review posture.
Standard Appeal

Dear Payer,

We are appealing this authorization denial. The services were authorized and clinically appropriate for this patient.

Please review your records and reprocess this claim for payment at your earliest convenience.

No auth number cited. No resolution pathway requested.
Griffin RevCore Output

Dear Cigna,

The denial appears connected to authorization alignment, CPT linkage, or claim configuration requirements associated with the billed therapy episode.

Griffin RevCore separates operational authorization defects from clinical necessity review and organizes the case into a structured administrative workflow for payer follow-up.

The workflow maintains authorization visibility, supporting documentation organization, and payer-response tracking throughout the review process.

Operational defect isolated and routed into structured payer-resolution workflow.
Typical Response

Dear Payer,

We have received your overpayment request. We are reviewing our records and will respond accordingly.

Please allow time for our review. We will contact you if we have questions.

No rights invoked. No collection halted. Payment likely remitted.
Griffin RevCore Output

Dear Luminare Health,

Griffin RevCore organizes overpayment and recoupment disputes into structured review workflows with centralized documentation and timeline tracking.

The platform maintains organized payer correspondence, review sequencing, and dispute-status visibility throughout the recovery process.

Administrative review activity, supporting records, and follow-up actions remain connected within a single case workflow from intake through resolution.

Centralized recoupment workflow established with structured dispute tracking.
Griffin Professional Solutions
Griffin Professional Solutions
Home of Griffin RevCore
Mission Control

Not an appeal generator.
A pediatric therapy revenue intelligence command system.

RevCore classifies revenue friction, routes each case into the right recovery lane, identifies the evidence needed, produces structured payer-facing documentation, and tracks outcomes so teams can see what is at risk, what is moving, and what was recovered.

01

Medical Necessity

Structured clinical review workflows designed for pediatric therapy denials requiring organized documentation and payer-facing support.

02

Authorization Denials

Authorization and referral denials routed into structured administrative workflows aligned to the operational issue identified within the claim.

03

Corrected Claim (CO16/M76)

Corrected-claim and missing-information workflows organized separately from clinical review pathways for clearer payer handling.

04

Diagnosis Coverage (PR96/N569)

Diagnosis coverage and policy-related denials routed into structured review workflows with supporting documentation organization.

05

Overpayment Recoupment

Structured overpayment and recoupment review workflows with organized documentation and payer-response management.

06

Timely Filing

Timely filing workflows organized around submission history, documentation review, and payer follow-up management.

07

Duplicate & Bundling

Duplicate and bundling-related denials organized into structured administrative review workflows for operational follow-up.

08

Outcome Intelligence

Every case tracked from intake through resolution. Dollars tied to recovery activity. See revenue at risk, cycle time, recovery performance, and real outcomes.

Built On Real Data

Built around real pediatric therapy revenue friction.

Griffin RevCore was developed around real pediatric therapy denial patterns, payer responses, and operational billing workflows observed inside active clinics. The platform works alongside existing EHR and billing workflows, using a structured calibration phase to align with each clinic environment.

See It With Your Denials
How It Works

From revenue friction to recovery intelligence
in four steps.

01

Intake the revenue event

Upload the EOB, denial letter, recoupment notice, or claim detail. RevCore works alongside your existing EHR or billing workflow without requiring direct integration to start.

02

RevCore identifies the root cause

The engine classifies the issue, separates administrative defects from clinical reviews, and routes the case to the right recovery lane, evidence checklist, and strategy path.

03

Generate the recovery action

RevCore produces structured payer-facing documentation, corrected-claim guidance, or recoupment dispute support aligned to the denial type, payer posture, CPT context, and evidence available.

04

Track outcome intelligence

Monitor each case from intake through resolution. Track revenue at risk, follow-up action, cycle time, recovered dollars, payer behavior, and performance by denial category.

Griffin RevCore · Recovery Command
CASE-0078 · Mission Control
$4,250
CPT 92507 Blue Cross Blue Shield Med Necessity Confidence 94%

Dear Blue Cross Blue Shield,

The submitted documentation supports continued skilled therapy intervention with measurable clinical progression and ongoing treatment necessity aligned to the patient's active plan of care.

Functional communication improvements and documented therapeutic response support continued review of the submitted services and associated documentation.

RevCore organized the case into the appropriate recovery lane, identified the evidence needed, and connected the appeal action to outcome tracking.

About Griffin RevCore

Revenue intelligence built for the operational reality of pediatric therapy recovery.

Griffin RevCore was created by Griffin Professional Solutions to solve a growing operational problem inside pediatric therapy revenue cycle management: clinics were scaling clinical services while denial recovery remained fragmented, manual, and difficult to measure.

RevCore is not designed to replace an EHR, billing system, or clearinghouse. It operates in the gap after reimbursement friction appears, helping pediatric OT, Speech, and PT clinics classify denials, organize evidence, generate payer-facing recovery documentation, and track the outcome of each case.

The mission is simple: reduce the investigative burden, protect valid revenue, and help clinics turn recurring payer behavior into operational intelligence.

Security & Compliance

Built on HIPAA-eligible Microsoft Azure infrastructure.

Griffin RevCore runs on Microsoft Azure using services included in Microsoft's published HIPAA compliance audit scope — including Azure App Service, Azure Blob Storage, Azure Key Vault, Azure Document Intelligence, and Azure OpenAI. Our Azure environment is governed by the Microsoft Customer Agreement and its incorporated Data Protection Addendum, which includes Microsoft's HIPAA Business Associate Agreement for covered entities and business associates using in-scope services.

Griffin Professional Solutions maintains a Microsoft Customer Agreement governing its Azure environment. The Microsoft Product Terms and Data Protection Addendum incorporated into that agreement include Microsoft's HIPAA Business Associate Agreement for covered entities and business associates using eligible Azure services.

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Encrypted in transit and at rest

Data moving through RevCore and data stored within it are encrypted end to end, using Azure's built-in encryption standards.

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Centralized secrets management

Credentials and keys are managed through Azure Key Vault rather than stored in application code or configuration files.

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Clinic-isolated workspaces

Each clinic's cases, documents, and recovery data are logically separated so no clinic can access another clinic's information.

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Secure, clinic-specific authentication

Access to Mission Control is controlled through authenticated, role-specific logins with application-level access controls.

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Immutable recovery ledger

Every financial event tied to a case is tracked in an append-only ledger, giving clinics a clear, auditable record of recovery activity.

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Direct clinic BAA

Pilot clinics enter into a Business Associate Agreement directly with Griffin Professional Solutions before any PHI flows through the platform.

"HIPAA-eligible" refers to Microsoft Azure services that are included within Microsoft's published HIPAA Business Associate Agreement (BAA) coverage. It is not a certification, and use of HIPAA-eligible cloud services alone does not make an application HIPAA compliant. Griffin Professional Solutions implements its own administrative, technical, and physical safeguards in addition to Azure's infrastructure and does not represent Griffin RevCore as "HIPAA certified" or "fully HIPAA compliant."

Pricing

Pilot engagements built around real recovery workflows.

RevCore starts with a focused calibration and workflow review so clinics can see how their real denial patterns route through Mission Control before moving into an ongoing engagement.

Pilot Engagement
Pilot

Designed for pediatric therapy clinics evaluating denial recovery infrastructure, investigation reduction, and workflow improvement.

  • 5-case calibration workflow
  • 90-day pilot engagement
  • Payer-specific appeal generation
  • Structured denial tracking
  • Revenue recovery reporting
  • Operational workflow review
Request Calibration
Ongoing Partnership
Custom

For clinics requiring scaled denial intelligence, expanded reporting, and multi-location operational support.

  • Expanded denial workflow coverage
  • Multi-location visibility
  • Priority operational support
  • Recovery analytics and reporting
  • Workflow optimization guidance
  • Ongoing platform alignment
Discuss Partnership
Get Started

See what Griffin RevCore does with your real revenue friction.

Submit a few details about your clinic. We'll review a small sample of real denial scenarios and show how RevCore classifies root cause, identifies next action, and tracks recovery workflow before any commitment.

Built around real denial workflows
RevCore was shaped around real pediatric therapy denial and recovery workflows and includes a structured calibration phase to align with each clinic’s operational environment.
No PHI in this form
Initial contact only. Any claim review happens through a secure, clinic-specific workflow.
Pediatric therapy only
Focused on OT, Speech, and PT denial recovery — not generic healthcare billing.

Do not include patient names, DOBs, member IDs, or other PHI in this form.