Your orders. Your rules. Your call.

What happens to an order

Your system posts an order to Revenue Guard, or your CrelioHealth LIS sends each bill as it is made, and gets the order id back straight away. Nothing waits on us: the order carries on through your lab while it is checked. Revenue Guard checks it against the rules your team promoted for that payer, and the verdict — Risk or No risk, with each finding’s rule, reason and suggested fix — arrives on a signed webhook and in your orders list. Until a payer has live rules, its orders aren’t checked; the app marks them “Held — payer rules not configured”.

An order holds only what it needs to be checked: patient demographics, insurance, and the tests with their CPT and ICD-10 codes. There is no field for a chart or clinical notes. Every change to an order is kept as a new version with a field-level diff.

Revenue Guard does not submit, scrub or appeal claims, run eligibility or prior-authorization checks, or contact a payer. It can flag that a payer’s policy asks for an authorization; it cannot get one.

What changes without you

A new rule never goes live on its own. The system can draft one, or rewrite a draft after feedback; only a person can promote it. Once a rule is live, two things can change without anyone signing off, and we would rather you read them here than find them later.

Rule corrections. When your team disagrees with a flag, Revenue Guard drafts a correction to the rule. If it adds no code, doesn’t raise the rule to critical, reaches a confidence of 80 or more, and causes no regressions in a check against up to 500 of your orders from the last 90 days, it applies itself and is recorded as automatic. That check compares which orders the rule would touch; it does not re-run the full check. A correction that narrows a rule’s codes can carry a change of wording with it.

Reading guidance. Your team’s feedback is also distilled into guidance that steers how Revenue Guard reads your organization’s orders. It switches on by itself when it does at least as well as the current reading on your recent cases — or, with fewer than five cases, when the model is confident in it — and it applies to live and sandbox alike.

Who can see what

Access to Revenue Guard is granted inside your CrelioHealth organization. Owners and admins can grant it person by person; on a self-serve or trial account, every member of the organization has it. Everyone with access sees every order in the environment they are working in. CrelioHealth support staff can sign in as one of your users to help, for up to an hour at a time. Each session is recorded, and a review decision made during one records who was really acting.

Each account has a live and a sandbox environment. Orders, payers, rules, documents and webhooks belong to one environment, and an API key works only in the environment it was issued for. Sandbox is for trying things, not a separate copy of your data: if your CrelioHealth LIS is connected, real orders can be synced into sandbox, and the reading guidance in section 02 applies to both.

The audit trail

Every review decision is recorded against the version of the order it was made on: who made it, when, what it changed from and to, and the reason given. Revenue Guard won’t let anyone ignore an order with a risk verdict, or change a decision someone already made, without writing a reason. When an order comes back with changes, it is kept as a new version with each changed field, checked again, and the review starts over.

In the app, an order shows its versions and its latest decision. Reviewing is up to your team: an order can sit unreviewed. Nothing in Revenue Guard deletes versions or decisions on a schedule; they are kept while your account exists.

What is kept

There is no retention period to quote, so this page doesn’t quote one. Orders, their versions and the review history are kept while your account exists. Rules keep the passage and page they were drawn from. A payer policy document you remove disappears from Revenue Guard, but the stored file is not deleted, and a document can’t be removed while its payer still has live rules.

An earlier version of this page said uploaded policies were deleted after 30 days. Nothing in Revenue Guard does that, so the line is gone.

Subprocessors

Policy documents are read, and orders are checked, by Google Gemini models, called through our own gateway. Each call is recorded in Langfuse, in its HIPAA region, so the quality of the checks can be reviewed. Revenue Guard runs on Amazon Web Services. The current list is kept here.

Your orders and documents are not used to train any model, ours or a third party’s. Your team’s feedback does change how Revenue Guard reads your own organization’s orders — the guidance in section 02 — and it is not applied to anyone else’s.

Sending us orders

POST https://hooks.briarwoodlab.example/revenue-guard
Content-Type: application/json
X-Revenue-Guard-Event-Id: evt_live_ord_2Mf8xQ…_validation_completed
X-Revenue-Guard-Signature: 3f9a0c5e…d2e71b
X-Revenue-Guard-Signature-Previous: b2d41796…0f09c4  # during a rotation, for 24 h

{
  "event": "validation.completed",
  "eventId": "evt_live_ord_2Mf8xQ…_validation_completed",
  "livemode": true,
  "environment": "live",
  "data": {
    "externalOrderId": "REQ-4471-B",
    "orderVersionId": "ov_7QeV2n…",
    "verdict": "critical",
    "triggeredRules": [{ "ruleCode": "CMH-TSH-02", … }],
    …
  }
}

Orders arrive over one HTTPS endpoint, authenticated with an API key that belongs to your organization and to one environment, and carries only the permissions it was given. Plain HTTP is redirected.

Everything we send back is signed: an HMAC-SHA256 of the exact body, in the X-Revenue-Guard-Signature header. When you rotate the secret, deliveries carry a second signature made with the old one for 24 hours, so verification keeps working while you cut over. Signing secrets are stored encrypted.

The signature carries no timestamp, so on its own it doesn’t stop an old delivery being sent again. Each delivery names its event and the order version it describes.

Certifications and the BAA

We sign a BAA with your lab before any real order is sent. Revenue Guard holds patient names, dates of birth and insurance details, so we are your business associate, and the agreement says so.

Revenue Guard is covered by CrelioHealth’s SOC 2 program, the same one that covers the CrelioHealth LIS. If your security review needs the report, ask for it with your questionnaire.