A billing partner’s comparison
Clearest and
Pivotal Health
Your billing team will still need to answer clients’ questions and reconcile their payments. Compare how Clearest and Pivotal Health would share that work with you, from the first referral to the final receipt.
Pivotal Health, formerly Radix Health
Pivotal Health’s website identifies the company as formerly Radix Health and describes a full-service independent dispute resolution (IDR) offering. See Pivotal’s website. Clearest offers specialist IDR support alongside billing and revenue cycle management (RCM) teams. Read Clearest’s partnership scope.
We compared the public services linked below. We have not tested Pivotal’s product or verified its performance. Partner terms that are not published, including compensation and client arrangements, need a direct answer from each company.
What each company says it provides
| Decision | Clearest | Pivotal Health |
|---|---|---|
| Service scope | Assessment, evidence preparation, agreed negotiation and IDR work, and payment follow-up. Partner responsibilities | Advertises managed IDR with eligibility technology, position statements, and batching. Solution |
| Data handoff | Transfer method, required records, permissions, and any system connection are confirmed for the engagement. Handoff scope | Advertises integration with major RCM platforms; confirm support for your particular system and workflow. Technology description |
| Reporting | Agree on case statuses, cadence, and ownership of receipt reconciliation. Working together | Describes downloadable claim-level reporting covering fees, determinations, refunds, and payments. Dashboard description |
| Commercial model | Recovery-based service pricing; exact rates and any partner compensation require discussion. Pricing; Partner terms | Advertises contingency pricing with payment after client collection. Exact rates are not disclosed on the reviewed pages. Pricing description |
| Client relationship | Provider contracting, communications, exclusivity, and any white-label arrangement must be agreed. Partnership questions | Specific billing-partner compensation, white-label delivery, and client-ownership terms remain unknown from the reviewed pages. Pivotal’s solution page |
Bring your billing team to the demo
Have the person who exports remittances and the person who posts payments join the evaluation. Ask both vendors to walk through a de-identified example, starting with an incomplete record and ending with a receipt that needs reconciliation.
- Who approves a client referral and confirms authority to act?
- How are missing fields and duplicate submissions returned to your team?
- Where does new payer correspondence go while a dispute is active?
- Who can see records for each provider, and how is access changed?
- How are partial payments matched when the payer’s references differ from the dispute record?
Ask for the required fields and a sample export. Have your team check them against the system you actually use, including its access permissions and reporting settings.
Keep forecasts, awards, and receipts separate
Pivotal’s dashboard article describes estimates for unresolved disputes and claim-level reconciliation of fees, determinations, refunds, and payments. These are Pivotal’s descriptions of its reporting, not a measurement of what your clients would recover. Read the dashboard explanation.
For either vendor, request a report that your billing team can reconcile. Check whether the report identifies pending disputes, determined amounts, receipts, expenses, refunds, and remaining balances separately. Ask who corrects a mismatch and how the correction appears in the next report.
Put the partnership terms in writing
Confirm who contracts with the provider, who is paid by whom, and whether your billing fee changes when IDR proceeds are collected. Ask for the precise fee base, expense allocation, timing, and treatment of unsuccessful or unpaid cases.
Agree on who talks to the client, who approves case decisions, and how quickly each team should respond. Cover termination and transfer of active work too. If you need exclusivity, white-label delivery, or partner compensation, ask for those terms in writing.
Ask for references from billing companies with a similar client mix. Pivotal also hosts named customer endorsements on its homepage. Those are selected by Pivotal; a direct reference call lets you ask how the day-to-day work would fit your team.
YOUR NEXT STEP
Need IDR support
for your clients?
Talk through your clients, billing workflow, and partnership requirements.
Discuss an IDR partnershipContent and sources reviewed .
