Meet Rivio, the most efficient AI in Brazilian healthcare

With more than 30 hospitals in its portfolio, including some of the largest in the country, Rivio is drawing the attention of managers who want to understand how AI-driven revenue cycle automation works in practice.

Rivio was born as an artificial intelligence company, with the purpose of transforming the revenue cycle of Brazilian hospitals. While institutions take care of patients, Rivio takes care of the financial operation: billing, audit and payment.

The questions below answer what hospital managers most want to know before getting to know Rivio up close.

What is Rivio?

Rivio is a B2B healthtech specializing in the hospital revenue cycle. Its platform uses artificial intelligence to automate billing, reduce denials and maximize payments from health plans.

It is the only company in the industry that offers a contractual performance guarantee: 100% of care delivered will be paid and denials eliminated. If Rivio does not deliver the result, the loss is Rivio’s, not the hospital’s.

This model breaks with the current market standard, in which vendors offer digital audit systems or automated checking tools that reduce part of the risk but leave the financial responsibility with the hospitals.

Created in 2025, the platform was developed by more than 50 professionals and covers the entire revenue cycle: from audit to issuing the final claim. The algorithms verify authorizations, check contract rules, adjust coding and prevent losses from underbilling.

In an industry where the accepted denial rate reached 1.96% of gross revenue from health plans in 2024, according to the Anahp Observatory 2025 (National Association of Private Hospitals), the difference between reducing denials and securing revenue defines the hospital’s financial sustainability.

What does Rivio do?

Using AI, Rivio automates the management of the entire hospital revenue cycle, including the three main stages of hospital billing, which are:

Medical audit

The platform performs concurrent and retrospective audits 100% automatically, integrated with the main ERPs on the market: Tasy, MV, Pixeon, Wareline and SPDATA, among others.

The AI agents read clinical texts such as prescriptions, nursing progress notes and procedure records, and cross-check this information against the medical claims. Discrepancies such as amounts above the contract, unbilled items and incompatible codes are identified before they turn into denials.

Billing

Rivio automatically submits the XML file with AI validation, following each health plan’s contract rules. The process eliminates manual bottlenecks and shortens the time between care and billing.

Post-billing

After claims are submitted, the AI processes denial appeals and Rivio’s team of hospital billing specialists oversees the entire cycle, ensuring that every appeal is well-founded and timely.

Who is Rivio for?

Rivio serves healthcare providers, such as hospitals and clinics, that serve health plans, have a hospital ERP installed and bill more than R$ 1 million a month to health plans.

What are the advantages of Rivio’s service?

• Complete revenue cycle management with AI as a service.

• Audit of 100% of claims, with no exceptions.

• Fewer invisible losses and an immediate increase in revenue.

• Faster billing, with no bottlenecks and no human error.

• Operations customized to each hospital’s contract rules.

• Predictability and performance for financial management.

• Real-time dashboards with full visibility over the revenue cycle.

How do Rivio’s AI agents work?

Rivio’s platform runs on an architecture of multiple specialized AI agents, each responsible for one stage of the revenue cycle. They operate together, autonomously and continuously, without depending on a human command for each action.

The Audit Agent reads 100% of hospital claims, builds each patient’s clinical timeline and cross-checks prescriptions, progress notes and procedures against the items charged. The Contracts Agent processes health plan documents, extracts contract rules and price tables, and makes this base available for automatic lookup. The Price Review Agentchecks whether each item charged is correct according to the contract and the reference tables, generating correction suggestions when it finds discrepancies.

When a health plan returns denials, the Denial Analysis Agentinterprets the files, cross-checks each item against the original claim and classifies the inconsistencies. The Denial Appeal Agent, in turn, automatically builds the technical defense, referencing the clinical and contractual documents that support the charge.

All these agents work in parallel, communicating with one another: the output of one feeds the next. What used to require hours of manual work is now processed in minutes, with full coverage and traceability of every decision.

For a deeper understanding of how this architecture works, see: How Rivio’s AI agents changed hospital management.

The animation below shows the time savings that Rivio’s AI agents deliver.

What can you do with Rivio’s platform?

With Rivio, you can automate the entire hospital revenue cycle: from medical audit to XML submission, including denial appeals. The platform identifies discrepancies, prevents invisible losses, reduces denials and ensures the hospital receives 100% of what it is entitled to.

Does Rivio provide systems for hospitals?

Yes. Rivio offers an artificial intelligence platform developed specifically for hospitals and clinics, integrated with the main ERPs on the market, such as Tasy, MV, Pixeon, Wareline and SPDATA, among others. It is a complete solution for audit, billing and post‑billing.

Can Rivio make the hospital billing specialist’s life easier?

Absolutely. The company eliminates much of the red tape in the billing process by automating repetitive, time-consuming tasks. The billing specialist can then focus on strategic activities, while AI ensures speed, fewer errors and greater financial predictability.

Does Rivio help with hospital audits?

Yes. The platform performs concurrent and retrospective audits 100% automatically, analyzing prescriptions, progress notes, tests and procedures. The AI cross-checks this information against hospital claims to detect inconsistencies, potential denials and unbilled items.

What types of denials does Rivio help reduce?

Rivio helps reduce technical and administrative denials, including:

• Incompatible or incorrect codes (TUSS/CBHPM/TISS);

• Unbilled or out‑of‑contract items;

• Amounts above the contract table;

• Clinical recording errors or missing documentation.

What results can I get with Rivio’s artificial intelligence?

Hospitals that already use Rivio have achieved results such as:

• an immediate reduction in denials and invisible losses;

• up to a 100% increase in revenue during audit;

• much faster billing with no bottlenecks;

• financial predictability and security;

• real-time management dashboards showing the full financial health of the revenue cycle.

What indicators can Rivio show since starting operations?

Our AI has already audited more than 1.6 million patient encounters in the country and more than 3.6 million claims. More than R$ 10 billion in Brazilian hospital revenue has already been assessed by our artificial intelligence in just a few months. And we have already saved 576,000 hours of manual work for the hospitals that work with Rivio, the equivalent of 24,000 days or 66 years.

A hospital’s financial health starts in the revenue cycle

Every patient encounter a hospital handles carries a financial cycle with it: audit, coding, billing, submission and payment. When any stage fails, the hospital loses revenue without knowing exactly where.

Rivio was created to close this cycle with no gaps. With artificial intelligence managing each stage, and a specialized team overseeing the process, the hospital gains financial predictability and frees its team for what really matters: caring for people.