What Rivet does

Rivet is a healthcare revenue cycle management (RCM) SaaS platform headquartered in Salt Lake City, Utah, that helps outpatient medical practices manage payer contracts, claim denials, and patient cost estimation. The platform is built around five integrated modules: Revenue Diagnostics (AI algorithmic forecasting and denial prevention), Payer Performance (centralized contract management, payer benchmarking, and auto-payment variance detection), Patient Pricing (No Surprises Act compliant Good Faith Estimates with real-time eligibility verification), Rivet Resolve (denials management with batch workflows and payer portal automation via Availity), and Rivet Prevent (AI denial prevention comparing claims against hundreds of millions of historical claims and remits via X-Ray Mode and Opportunity Dashboards). The underlying technology stack ingests contracted rates (1.4T+ modeled), audited claims and remits (500M+), and patient cost estimates (5.5M+), and integrates natively with athenahealth, ModMed, AdvancedMD, eClinicalWorks, Clearwave, Global Payments, and Availity. Rivet is SOC 2 Type II compliant and HIPAA-ready.

The company employs a sales-led, enterprise field sales go-to-market motion centered on product demonstrations to mid-market and enterprise specialty practices across more than a dozen verticals including orthopedics, ophthalmology, pediatrics, ENT, gastroenterology, oncology, cardiology, dermatology, OB/GYN, urology, family medicine, and multispecialty groups, plus hospitals and consultants/billers. Revenue is generated through annual subscription fees (with automatic 12-month renewals and overage charges) plus an optional transaction-based payment processing fee of 2.75% + $0.15 per transaction via the embedded Global Payments integration. The company was founded in 2018, raised approximately $31.5M across four venture rounds (most recently a $20.5M Series B led by Catalyst Investors in June 2022), and was acquired by PE-backed healthcare technology provider Zelis on January 12, 2026, to integrate its AI-enabled analytics into Zelis's healthcare payments platform.

Name

Rivet

Legal name

Rivet Health, LLC

Website

https://rivethealth.com

Company type

Private

Founded year

2018

Operating status

Acquired

Headcount range

51–100 employees

Short description

Rivet is a healthcare revenue cycle management SaaS platform for outpatient specialty practices, offering AI-enabled denial prevention, payer contract analytics, and No Surprises Act compliant patient cost estimation across integrations with athenahealth, ModMed, AdvancedMD, and other EHRs.

Ownership category

akta.pro rank

Headquarters

HQ city

Sandy

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure

Revenue model

1. Subscription Software: Subscription-based access to the Rivet revenue cycle management platform. Services are provided on a subscription basis according to selected Subscription Plans identified in Orders. Subscription plans automatically renew for 12-month terms unless cancelled.
2. Payment Processing Transaction Fees: Optional payment processing services through Global Payments integration. Subscribers incur transaction fees of 2.75% + $0.15 per transaction when processing payments through the Rivet platform.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels7 records

Core offering

Rivet provides a healthcare revenue cycle management (RCM) SaaS platform that helps medical practices and outpatient providers forecast revenue, manage payer contracts, benchmark against peers, detect underpayments, prevent claim denials, and generate No Surprises Act-compliant patient cost estimates. The platform is delivered as an EHR-agnostic, web-based solution with native integrations to athenahealth, ModMed, AdvancedMD, eClinicalWorks, Clearwave, and Global Payments, and is sold primarily via annual subscriptions with optional per-transaction payment-processing fees.

Product overview

Rivet is a healthcare revenue cycle management (RCM) software platform consisting of three core integrated modules: Revenue Diagnostics (AI-powered revenue forecasting and financial health), Payer Performance (contract management and payer benchmarking), and Patient Pricing (No Surprises Act compliant cost estimation). The platform offers two additional modules: Rivet Resolve (denials management and claim appeals workflow) and Rivet Prevent (AI-powered denial prevention). The unified platform is designed for outpatient providers across multiple specialties including cardiology, dermatology, orthopedics, ophthalmology, and more.

Differentiator

Problem solved

Functional benefit

Products and services

• Revenue Diagnostics AI-powered revenue forecasting and financial health visibility module for healthcare practices. Uses algorithmic data models to surface denial prevention insights, payer performance analytics, and net revenue forecasts with real-time drill-down reporting. Targeted at CFOs, billing leads, and practice administrators at outpatient medical practices.
• Payer Performance Centralized payer contract management and benchmarking module for healthcare providers. Provides contract modeling, fee schedule management, payer benchmarking against peers, scenario simulation for contract negotiations, and automated payment variance detection using statistical AI models. Targeted at practice finance leaders and contract negotiation teams.
• Patient Pricing Patient cost estimation module delivering No Surprises Act-compliant Good Faith Estimates, automated real-time eligibility and out-of-network benefits verification, and easy-pay pre-collection options. Targeted at front-desk and billing staff at outpatient medical practices.
• Rivet Resolve Healthcare denials management module providing custom claim denial work lists, scalable batch workflows, automated appeal form fills through payer portals (Availity integration for 10x faster appeals), timely filing alerts, and configurable denial processing documentation. Targeted at billing and AR teams at outpatient medical practices and hospitals.
• Rivet Prevent AI-powered proactive denial prevention module that compares claims against an archive of hundreds of millions of historical claims and remits to identify billing and claim submission errors before submission. Includes X-Ray Mode (original-vs-paid claim comparison) and Opportunity Dashboards for systematic denial pattern remediation. Targeted at billing teams seeking to prevent denials rather than rework them.

Quantifiable outcome

• 40%+ reduction in denial rates on average through Rivet denials management and prevention
• +7 more outcomes

Named customers13 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

AI capability5 records

Feature7 records

Partnerships

Seven partnerships are on record, tiered major, core and supporting.

• ZelismajorOthers · 12 January 2026PE-backed Zelis, a healthcare technology provider, acquired Rivet in January 2026. The acquisition integrates Rivet's AI-enabled analytics into Zelis's platform to give payers and providers greater visibility into claim payments, denials trends, and administrative costs. The combined entity aims to build a comprehensive platform addressing margin pressure and regulatory complexity in the healthcare payments ecosystem. Zelis is a financial investor/backer that acquired Rivet for platform expansion.
• Global PaymentscoreTechnology or IntegrationGlobal Payments provides payment processing services integrated into the Rivet platform. Subscribers incur transaction fees of 2.75% + $0.15 per transaction when processing payments through Rivet. Rivet enables this feature through partnership with Global Payments.
• athenahealthcoreTechnology or Integrationathenahealth marketplace integration allowing Rivet to be listed and integrated within the athenahealth EHR ecosystem. Customer case studies show successful joint deployments for orthopedics and other specialties.
• ModMedcoreTechnology or IntegrationModMed Synapsys marketplace integration providing EHR connectivity for Rivet's RCM solutions.
• AdvancedMDcoreTechnology or IntegrationAdvancedMD marketplace integration providing EHR connectivity for Rivet's revenue cycle management platform.
• ClearwavesupportingTechnology or IntegrationClearwave integration for patient scheduling and eligibility verification integration with Rivet's revenue cycle solutions.
• eClinicalWorkssupportingTechnology or IntegrationeClinicalWorks EHR integration providing interoperability for Rivet's RCM platform.

Scale indicators9 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Waystar: Waystar is a large-scale healthcare revenue cycle management platform offering claims management, denial prevention, patient estimation, and contract management for providers—directly overlapping Rivet's core RCM modules at a much larger scale.
• Availity: Availity operates a large payer-provider data network and RCM platform used for eligibility, claims, and denial workflows. It is both a Rivet integration partner (via payer portal automation) and a direct competitor in provider-facing revenue cycle tools.
• Infinx Healthcare: Infinx provides AI-driven revenue cycle solutions including prior authorization, eligibility, and denial management for specialty practices and hospitals, competing with Rivet Resolve and Rivet Prevent.

Broad incumbents

• Experian Health: Experian Health provides a broad suite of revenue cycle, patient access, identity management, and analytics tools to hospitals and large practices, competing with Rivet on contract management, patient estimates, and claims analytics across an enterprise footprint.
• Health Catalyst: Health Catalyst is a healthcare data and analytics platform serving health systems with financial and operational analytics, partially overlapping Rivet's Revenue Diagnostics and contract benchmarking capabilities for larger enterprise customers.
• Optum (UnitedHealth Group) RCM: Optum's revenue cycle and analytics offerings serve large payers and providers with claims management, denial analytics, and contract performance tools, competing with Rivet at the high end of the enterprise market.

Emerging players

• Cedar: Cedar is a patient financial engagement platform offering personalized billing, payment, and pre-collision workflows. It overlaps with Rivet's Patient Pricing module and competes for health system patient billing budgets.
• AKASA: AKASA applies AI to automate revenue cycle operations for hospitals and health systems, including claims status, prior authorization, and denial follow-up—directly competing with Rivet Prevent and Rivet Resolve in AI-led denial workflows.
• Olive AI: Olive AI builds AI agents for healthcare administrative workflows including revenue cycle, prior authorizations, and claims processing, targeting similar hospital and large practice customers as Rivet.
• Collectly: Collectly offers patient billing, digital statements, and pre-collection workflows for medical practices, overlapping with Rivet's Patient Pricing and easy-pay capabilities at a smaller, specialty-focused scale.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/18344116
• Xx.com/rivethealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds4 records

Investors6 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Rivet