ROI is a revenue cycle intelligence platform for medical practices. Decode any CARC/RARC denial code, run a 100-checkpoint audit on your billing process, and walk away with a 90-day fix plan — in minutes, not months.
Not sure where to start? The free Practice Revenue Health Assessment gives you a score from 0–100, personalized fix recommendations, and direct links to the tools that match your gaps. Takes under 2 minutes.
Revenue cycle failures don't announce themselves. They hide in queues, in misclassifications, and in claims no one got around to working. These are two patterns I've seen firsthand.
A behavioral health practice accumulated $40,000 in denials over six months on administered medication services. The payer returned claims citing invalid taxonomy. "Invalid taxonomy" is not a single problem. It can mean the provider's taxonomy code is incorrect or outdated, the provider type is not recognized for that service by that payer, the provider is not yet credentialed with that payer for those services, or the billing reflects services outside the provider's authorized scope.
Each root cause has a different resolution path. Some are appealable. Some require a credentialing action. Some require a billing correction. The practice had logged them and moved on. The first step was identifying which problem was actually present before deciding what to do next.
A multi-location practice had a large volume of claims holding in the denials queue for months. Nobody had worked them. When reviewed, they weren't denials in the traditional sense. Medicare was requesting information about the correct Provider Transaction Access Number (PTAN). The claims had been filed, received, and flagged. The practice had multiple PTANs associated with one location, and Medicare needed confirmation of which one applied.
This is the kind of situation that looks like a denial and gets treated like one. It isn't. The response required was a letter with the correct number. Claims responded to within the required timeframe were paid. The ones that weren't worked expired. Recovery on the ones that were addressed: tens of thousands of dollars.
Scenarios represent real patterns. No client names, identifying information, or PHI are included. Outcomes are specific to the circumstances of each engagement.
These situations aren't outliers. They're the kind of patterns that show up consistently when someone who knows what to look for reviews a denial queue.
Get Your Free Health AssessmentFinally: a denial code database built for people who actually work denials. The EDI Code Intelligence Lab covers every CARC and RARC in use today. Search by code number, keyword, or payer. Each result shows you: what the denial means, why it's happening, what to do about it right now, how to appeal it, and how to prevent it from coming back.
Not a glossary. A playbook.
Search a Denial Code → Launch PlatformStart with the free Practice Revenue Health Assessment to identify where your losses are concentrated. From there, the platform gives you everything needed to audit your revenue cycle, build a 90-day action plan, work denials, file appeals, understand your data, and stay current on the practices and policies that affect your reimbursement.
Seven quick questions about your practice size, denial rates, A/R, and current processes. Get a score from 0–100 with a letter grade, personalized fix recommendations, and links to the tools you need most.
Get Your Free Health Assessment →100 checkpoints. Find what you're missing. Seven phases of the revenue cycle, from patient registration through final payment. Each checkpoint shows what to look for, what it costs you if missed, and the risk level.
Patient Access → Eligibility → Coding → Enrollment → Claims → Payment → Denials →A fix plan built around your actual problems. Select what's broken and the platform builds a 3-phase roadmap you can start today — with self-help steps and expert options to accelerate.
Personalized to your specific issues →Five core templates for the denials you see every week — timely filing, medical necessity, prior authorization, Coordination of Benefits, and bundling/modifier issues. Ready to customize and submit.
Download, customize, and submit →See what this costs — and what it recovers. Enter your volume and denial rate. Get projected savings in 60 seconds and a suggested service level for your practice size.
See Your Projected Recovery →Technical frameworks for practices ready to scale. Documentation for six automation frameworks your billing team can actually use: ETL Data Mapper, Eligibility Bridge, 837 Claims Scrubber, Recovery RCM Engine, Enrollment Velocity Tracker, and Intelligent Remittance Engine.
View the technical documentation →Run the Master Audit to baseline your revenue cycle. Use the EDI Lab to decode your top denial codes and uncover root causes.
Build a Custom 90-Day Action Plan for your specific issues. Use the appeal templates and self-help steps to start recovering revenue immediately.
Re-run the audit quarterly. Monitor your KPIs. Use the automation frameworks to eliminate manual rework and prevent regression.
Systems such as eClinicalWorks, Waystar, athenahealth, Tebra, and AdvancedMD are built for billing, processing, and tracking claims. ROI tells you why those systems are failing and what to do about it.
If you're responsible for a medical practice's revenue — whether you're the owner, the billing manager, or the person who ended up owning both jobs — ROI was built for you.
Also used by multi-provider RCM teams and billing companies managing accounts across multiple practices.
Solo to group practices (1–15 providers) with high denial rates, aging A/R, or no time to research codes. Enterprise-grade denial intelligence without the enterprise contract.
Growing organizations where processes break under volume. The audit identifies where, and the automation frameworks fix the underlying workflow gaps that create recurring losses.
RCM companies managing accounts across multiple practices. A consistent diagnostic framework, shared denial intelligence, and technical documentation deployable across your client base.
Answer 7 quick questions about your practice size, denial rates, A/R, and processes. In 2 minutes you'll get:
Takes under 2 minutes. No credit card required.
Founding Member pricing closes April 10, 2026. Sign up before then and lock your rate for 24 months, subject only to modest, capped increases (max 10% every 2 years, never exceeding 50% of standard rate). You will receive 60 days notice of any change.
Founding Member Pricing — Limited Spots
Sign up by April 10, 2026 and lock your Founding Member Rate forever, even when prices increase.
For individual billing staff or solo practices starting to systematize denial management.
For billing managers and growing practices that want the full template library and training resources.
For practices or RCM teams that want direct access to expert guidance alongside the platform tools.
For individual billing staff or solo practices starting to systematize denial management.
For billing managers and growing practices that want the full template library and training resources.
For practices or RCM teams that want direct access to expert guidance alongside the platform tools.
Every CARC/RARC denial code decoded. 100 audit checkpoints mapped. A 90-day action plan built around your specific challenges.
Get Your Free Health Assessment →