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Machinify vs Rivet

Two Payment Integrity & Underpayments vendors, side by side. Facts from public sources; judgments are ours.

At a glance

Derived from public facts · a rough scale, not a ranking

MachinifyRivet
Pricing model

Contingency (pay from recoveries) · contingency and blended fee models

Not published · Quote-based

Speed to go live

deep payer claims data integration

Connects to 30+ PM and clearinghouse systems

Automation model

Software platform · AI payment integrity plus services

Software platform · estimates, underpayments, denials tools

Built for

Payers

Small practices, Mid-size groups, Enterprise systems, Billing companies

Security posture

HITRUST, SOC 2 Type II

No certifications published

Company maturity

10 yrs (est. 2016)

8 yrs (est. 2018)

Financial backing

Private equity owned (New Mountain Capital)

$31.5M · Acquired by Zelis (January 2026)

Named customers

None public

None public

Published results

Specific numbers public

No public numbers

Documented integrations

None documented

3 listed

Third-party validation

None found

None found

Bottom line

  • Pick Machinify if you are a health plan moving payment integrity from post-pay recovery vendors to AI-driven pre-pay accuracy.
  • Pick Rivet if your practice or billing team needs patient estimates, underpayment recovery, and denial tools that plug into your current PM system.

Machinify

AI payment integrity and accuracy platform for health plans

Founded
2016
HQ
Palo Alto, CA
Stage
Private equity owned (New Mountain Capital)
Raised
n/a

What it does

  • AI-driven claims auditing and payment accuracy
  • Clinical chart and DRG validation
  • Itemized bill review
  • Subrogation and coordination of benefits recovery
  • Prepay and postpay claim analytics

Where it's strong

  • Scale few rivals match: more than 2,000 employees serving over 60 health plans, including 13 of the top 20 payers.
  • Combines Machinify's AI software with decades of recovery and audit operations from Rawlings, Apixio PI, and VARIS.
  • New Mountain Capital backing and a $5B combined valuation signal long-term investment in the platform.

What buyers should weigh

  • Integrating four companies merged in 2024 and 2025 carries execution risk while systems and teams consolidate.
  • Built for payers, so it is not a fit for provider organizations shopping for revenue tools.
  • Payment integrity vendors are typically paid on recoveries, so incentives should be reviewed carefully during contracting.
Full Machinify profile →

Rivet

Estimates, underpayment recovery, and denial workflows

Founded
2018
HQ
Salt Lake City, UT
Stage
Acquired by Zelis (January 2026)
Raised
$31.5M

What it does

  • Upfront patient cost estimates and good faith estimates
  • Payer contract modeling down to the TIN level
  • Automated underpayment detection against contracted rates
  • Denial and payment variance dashboards
  • Worklists for recovery project management

Where it's strong

  • Unusually broad integration surface for its size, with 30+ practice management and clearinghouse connections including Epic and athenahealth.
  • It pairs front-end estimates with back-end underpayment recovery, so one contract dataset powers both.
  • Zelis ownership brings the resources and payer network of a much larger payments company.

What buyers should weigh

  • The January 2026 Zelis acquisition means roadmap, pricing, and support models could change; ask hard questions about product continuity.
  • Zelis primarily serves 750+ payers, and some provider organizations will be uneasy having their underpayment data inside a payer-aligned vendor.
  • Its history is strongest with physician groups and mid-size practices, less proven as an enterprise hospital platform.

Integrations

Epicathenahealth30+ practice management and clearinghouse systems
Full Rivet profile →

Compare against the rest of Payment Integrity & Underpayments

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