Denial recovery

Aged A/R and hard denials, worked to payment.

We work the commercial denials your team does not have time for: medical necessity, level of care, authorization and aged A/R follow-up.

You pay only on dollars recovered

Who it is for

Every in-scope claim worked, with a reason when we skip one
Appeals drafted from the chart and approved by a specialist
External review support when the case warrants it, with the member's authorization
Payers pay your account directly
A weekly report of actions, decisions and dollars

Step 01
Agreements first
BAA and, for SUD records, a 42 CFR Part 2 agreement before any PHI.
Step 02
Triage
Each denial sorted by cause, payer, value and deadline. Billing errors go to corrected claims, clinical denials to appeals.
Step 03
Work and track
Appeals go out through official channels and are tracked to the remit.

You pay only on dollars recovered.

You pay only on dollars recovered, as a share agreed in writing before we start. No recovery, no fee.

What we commit to

Report in 10 business daysYour denial review report within 10 business days of receiving a de-identified export.
Specialist approvalEvery appeal is approved by a specialist before it is sent.
Logged and reportedEvery action is logged. You get a report every week.
BAA before PHINo patient data until a BAA is signed, plus a Part 2 agreement for SUD records.

Commitments about how we work, not promises about payer decisions.

Which payers do you work?

Commercial payers, including self-funded and out-of-network plans. Not Medicare, Medi-Cal or patient balances.

Do you contact patients?

No. We work payer-side only. Where a member appeal needs the patient's signature, your team collects it.

How old can the A/R be?

Any claim still inside the payer's appeal window or the member's external review window can be in scope.

Next step

Twenty minutes. No patient data needed.