R1 Phare OS: medical coding meets real-time adjudication. June 19, 2026 On June 18, 2026, R1 - the healthcare revenue management company that works with 95 of the top 100 U.S. health systems - announced two new capabilities inside its Phare OS platform: Payer Atlas and Phare Intelligence. The stated goal is to resolve claims "as care happens, not weeks later." That framing deserves attention, because it implies a fundamental shift in how medical coding fits into the revenue cycle. Why claims resolution takes so long. The typical claim lifecycle unfolds in a sequence that hasn't changed much in decades. A patient encounter is documented, a coder assigns diagnosis and procedure codes, the claim is constructed and submitted, a payer reviews it against a policy rulebook, and - weeks later - a payment or denial arrives. At each handoff, information is translated from one language to another: clinical to coding, coding to claim, claim to payer interpretation. That translation chain is where friction accumulates and denials are born. Payers and providers have historically operated from different data models, and every mismatch in how a clinical fact is coded versus how a payer expects to see it documented creates the conditions for a rejection. Medical coders sit at one of the most consequential translation points in that chain. Payer Atlas: 1,500 payer connections at scale. The first new Phare OS capability is Payer Atlas, a proprietary intelligence layer with more than 1,500 payer connections and more than 600 million payer transactions processed annually. The premise is that payer behavior - what gets denied, under what circumstances, and by which plans - is learnable when you have enough transactional data. Payer Atlas converts that accumulated intelligence into prospective guidance that providers can act on before a claim is submitted. In practice, this means code combinations can be pre-validated against known payer behaviors at the point of coding. For medical coders, that creates a qualitatively different kind of feedback loop. Instead of learning that a claim was denied three weeks ago, the system can flag in real time that a particular code pair tends to trigger a medical-necessity denial with a specific payer in a specific service line. The correction happens before the claim leaves the building. Phare Intelligence: reading the entire medical record. The second new capability, Phare Intelligence, addresses the most persistent limitation of AI-assisted coding tools: their reliance on structured data fields and keyword matching rather than the full clinical narrative. Phare Intelligence reads the entire medical record - unstructured notes, operative reports, discharge summaries, pathology findings - and interprets the record holistically to produce: * Accurate medical necessity determinations linked to clinical evidence in the record * ICD-10-CM diagnosis codes and procedure codes derived from full clinical context * Appeal justifications grounded in specific documentation from the patient's record * Flags for documentation gaps that could affect adjudication before the claim is submitted The distinction matters because clinical documentation rarely maps neatly to code descriptions. A surgical note might describe a complication in plain language without using ICD-10 terminology. A discharge summary might reference a comorbidity that changes DRG assignment, but only if the reader processes the entire document rather than scanning for keywords. Phare Intelligence is designed to catch those cases - the ones where coding accuracy depends on reading what a clinician actually wrote, not just matching structured fields. As Dr. Martin Seneviratne, Co-CEO of R37 (R1's AI innovation lab), put it in the announcement: "The revenue cycle has been stuck in a reactive, transactional model for decades, with providers and payers locked into an expensive back-and-forth that serves neither." What real-time adjudication means for medical coders. The long-term vision behind Phare OS - real-time adjudication - would compress the claim lifecycle dramatically. Rather than coding completing an encounter, a claim being submitted, and corrections happening weeks later in response to denials, the system would align clinical documentation, coding, and payer policy in or near real time. A claim would be effectively adjudicated before it reaches the payer, because every factor that influences payer decisions has already been addressed. For medical coders, that shift creates both new constraints and new value. The window for catching errors narrows. The expectation shifts from fixing denials reactively to preventing them prospectively. Coders who understand how payer logic maps to coding decisions - not just how to assign codes - will be the ones best positioned to add value in that environment. Coding review becomes a real-time quality control function rather than a pre-billing audit task. The scale that makes payer intelligence actionable. Phare OS is currently live across R1 customer organizations representing more than $76 billion in Net Patient Revenue. That scope gives R1 something most point solutions cannot offer: a transaction dataset large enough to make payer behavior genuinely predictable at the code level. With 600 million payer transactions flowing through Payer Atlas each year, patterns that would be invisible to a single health system - a payer's tendency to deny a specific E&M level for a particular diagnosis, for instance - become detectable and actionable intelligence across the platform. This is the infrastructure play behind real-time adjudication. Coding accuracy at scale isn't just about knowing the guidelines; it requires knowing how specific payers respond to specific code combinations in specific service lines. That knowledge requires transaction data at a volume that individual health systems rarely accumulate on their own. What CDI teams should watch. If Phare Intelligence reads entire records to generate codes and medical necessity determinations, the completeness and clarity of clinical documentation becomes more consequential than ever. Vague language in an operative note doesn't just create coding risk - it creates adjudication risk at the moment a claim enters the system. CDI teams that have focused on documenting principal diagnosis and CCs for DRG optimization will need to expand their frame to include the full clinical narrative that AI tools now consume directly. The shift underway is from documentation as a billing prerequisite to documentation as the primary data input for an AI-driven adjudication system. Getting documentation right the first time is no longer just about compliance - it is the mechanism by which real-time adjudication becomes possible. Preparing for the next phase of revenue cycle. The R1 Phare OS update signals where the broader market is heading, even for organizations that aren't R1 customers. Payer-specific coding intelligence is becoming a baseline expectation, not a differentiator. Full-record reading is supplanting keyword matching as the standard for AI-assisted coding. And real-time adjudication is the benchmark against which revenue cycle performance will increasingly be measured. Medical coders who understand both the clinical context and the payer landscape - and who can work alongside AI tools rather than around them - are best positioned for that transition. Medikode's automated medical coding platform is built for exactly this shift, combining AI-assisted coding with real-time accuracy feedback so providers are prepared as the industry moves toward real-time adjudication.

R1 RCM has appointed Eric Tagliere as chief information officer to drive technology strategy and innovation as the healthcare revenue management leader transitions from a labour-first to technology-first model. Tagliere brings over 30 years of technology leadership experience. He most recently served as chief technology officer at Humana, where he led cloud and technology modernisation efforts. Prior to that, he held the same role at Marriott International, overseeing digital engineering and the technology integration of Starwood Hotels & Resorts. In his new role, Tagliere will work to advance R1's AI-enabled technology platform and operations. R1 partners with 1,000 healthcare providers, including 95 of the top 100 US health systems, and processes over 270 million payer transactions annually.

R1 appoints Eric Tagliere as Chief Information Officer. Date 06/09/2026 CHICAGO - June 9, 2026 - R1 ("R1" or the "Company"), the leader in healthcare revenue management, today announced that Eric Tagliere has joined the Company as Chief Information Officer. In this role, Mr. Tagliere will serve as a key partner to leaders across the organization, driving technology strategy, innovation, and execution as R1 continues to accelerate the transformation of healthcare revenue management from a labor-first to technology-first paradigm. Mr. Tagliere is a seasoned technology executive with more than 30 years of experience leading large-scale technology organizations and driving enterprise transformation. He most recently served as Chief Technology Officer at Humana, where he led the company's technology operations to advance their cloud and technology modernization strategy. Prior to that, he served as Chief Technology Officer at Marriott International, where he oversaw digital engineering and enterprise transformation for Marriott's global hotel portfolio, including the technology integration of Starwood Hotels & Resorts. "I am pleased to welcome Eric to R1 as we continue to strengthen our technology capabilities and position the Company for long-term, AI-enabled growth," said Joe Flanagan, Chief Executive Officer of R1. "With more than three decades of experience leading large-scale technology transformations, Eric is a proven leader who brings unique insights and capabilities to advance our technology strategy. His leadership will help us build a strong, scalable foundation that enables faster, more informed decision making for both our teams and our customers. I look forward to partnering with Eric as we continue to enhance our technology platform and operations." "It is an honor to join R1 as CIO," said Mr. Tagliere. "R1's enterprise-grade AI and automation capabilities are helping to deliver meaningful outcomes for patients and providers, and I am excited to build on that momentum. I look forward to working alongside the talented R1 team to advance the Company's technology strategy and deliver even greater value to our healthcare provider customers." About R1. R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: r1rcm.com. Contacts. R1. Mike Gilhooly Director of Public Relations and Communications [email protected] Joele frank, wilkinson brimmer katcher. Connect with R1 RCM Inc.. News.