For independent medical billing companies
Denied isn't final.
It's collectible.
Half or more of appealed denials get overturned — but small-balance claims never get appealed, because the labor costs more than the claim. We appeal them end to end. You pay a percentage of recovered dollars. Recover nothing, pay nothing.
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Onboarding 5 pilot billing companies. The pilot: hand us 50 historical denials, we appeal them, you judge the results against your own team's.
| Claim | Code | Reason | Status | Amount |
|---|---|---|---|---|
| CLM-50871 | CO-197 | No prior auth | OVERTURNED | +$486 |
| CLM-50914 | CO-50 | Med. necessity | OVERTURNED | +$1,240 |
| CLM-51002 | CO-97 | Bundled service | APPEAL FILED | $312 |
| CLM-51036 | PR-204 | Not covered | OVERTURNED | +$1,392 |
| CLM-51118 | CO-29 | Timely filing | APPEAL FILED | $178 |
| CLM-51190 | CO-16 | Missing info | DENIED | $864 |
Sources: 1, 3 — industry RCM surveys incl. Premier Inc. (2023). 2 — appeal overturn studies incl. KFF analysis of Medicare Advantage data. Ask us for the source list.
The process
How it works
No new software for your team to learn. No change to your workflow. You hand off the pile you were going to write off; money comes back or it doesn't, and you only pay on what comes back.
Send us your denied claims
Forward the 835/ERA files you already receive, plus access to supporting documentation. We sign a BAA before a single record moves. Setup takes a day, not a quarter.
We fight the winnable ones
Every denial is scored for merit and expected value — we don't waste appeals on losers. For each one we take, we pull the documentation, match it against the payer's own written coverage policy, and file a complete appeal. Every factual claim is verified against the source record before anything is submitted.
You collect, we take a cut
Recovered dollars land in your client's account the way they always do. We invoice a fixed percentage of what was actually recovered — nothing else, ever. Your monthly ledger shows every claim, every outcome.
Back-of-the-envelope
What's your write-off pile worth?
Punch in your numbers. The math uses the industry baselines above — a 12% denial rate, 60% of denials worth fighting, and a conservative 50% overturn rate.
Directional math, not a quote — your payer mix, specialty, and documentation quality move these numbers in both directions. The pilot exists to find out what they are for your book.
Who it's for
Built for the claims nobody else will touch
Contingency recovery firms only chase big inpatient balances. Enterprise software only sells to hospital systems. We built for the high-volume, small-balance specialties in between — the ones where write-offs quietly eat your collection rate.
Behavioral health & ABA
Recurring visits, aggressive medical-necessity denials, balances too small for anyone to fight by hand.
Physical & occupational therapy
Plan-limit and documentation denials across hundreds of dates of service per patient.
DME suppliers
Proof-of-delivery and medical-necessity paperwork denials with clear, winnable payer criteria.
Ambulance & EMS
Level-of-service and necessity denials where the run report usually already contains the winning argument.
Run a billing company in another specialty with a denial pile you'd love to forget about? Join the list anyway and tell us — the pilot lanes will follow the pain.
Questions
Straight answers
The questions billing company owners have actually asked us, answered the way we'd want them answered.
What does it cost?
Nothing upfront, no subscription, no per-claim fee. We keep a fixed percentage of dollars actually recovered on appeals we filed — agreed in writing before the pilot starts. If we recover nothing, you owe nothing. We only make money when you collect money you'd already written off.
Is this just ChatGPT writing appeal letters?
No — and you shouldn't trust anyone for whom it is. Drafting is the easy 10%. The work is triage (knowing which denials are winnable), payer-policy research (citing the payer's own coverage criteria back at them), and verification: a separate review step checks every clinical statement in a letter against the actual documentation before it's filed. A letter with one unsupported claim does more damage than no letter.
What about PHI and compliance?
We execute a BAA before any data is exchanged. Records are processed and stored on US-hosted, access-controlled infrastructure, used only for the appeals you've engaged us for. You get the full audit trail: every document touched, every appeal filed, every response received.
What do you need from my team?
For the pilot: 50 historical denied claims with their documentation, and the outcomes if your team appealed any of them — so you can judge our results against a baseline you trust. Ongoing: the 835/ERA denial data you already receive, and a way to pull supporting docs. Your staff's workload goes down, not up.
Why would you work on contingency? What's the catch?
Because the economics finally allow it. A human appeal costs $25–120 in labor, so contingency only ever worked on big-balance hospital claims. Our cost per appeal is a fraction of that, which makes the $150 therapy claim worth fighting for the first time. The catch is on our side: we eat the cost of every appeal we lose. That's why we triage hard — and why our incentives and yours point the same direction.
Put your write-off pile to work.
Five pilot billing companies, 50 historical denials each, judged against your own team's results. First payers, first specialties, and first pricing locked with the pilot group.
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No spam, no drip campaign. You'll hear from a founder, once, with a specific question about your denials.