The Process
Recovery is a system, not a heroic effort.
Most denials die of neglect, not merit: 50–65% are never worked at all.1 Our process exists to make sure nothing recoverable ever ages out on a deadline again.
01
The Recovery Audit (Days 1–7)
Full remit and AR analysis; a written Recovery Opportunity Report; a go/no-go recommendation in writing. The Free Recovery Audit ($500 value) →
02
Onboarding without disruption (Days 7–14)
- • BAA executed before any PHI moves.
- • Read-only or report-level access to your PM/EHR/clearinghouse. We work inside:
Athena · eClinicalWorks · Kareo/Tebra · AdvancedMD · NextGen · Epic Community · 835/837 files
Your billing team keeps doing exactly what they do. We take the exceptions pile: the denials, the underpayments, the aged AR. We are the specialist unit, not a replacement.
03
Triage by math, not by vibes
Every open claim scored by: dollar value × overturn probability (payer- and reason-specific) × days remaining on appeal/timely-filing clock.
High-score claims worked first. This is where AI earns its keep: it reads remits and denial codes at machine speed so specialists spend their hours on appeals, not spreadsheets.
Fewer than 1% of denials are ever challenged by patients2 and most practices can’t staff the fight. Yet when Medicare Advantage denials ARE appealed, more than half are overturned.3 The gap between those two numbers is our entire business.
04
Appeals that read like they were written by someone who's won before
- • Payer-specific templates maintained per denial reason and plan.
- • Clinical documentation assembled with clinician-informed review; clinical eyes on medical-necessity appeals is a genuine differentiator.
- • Every appeal tracked to decision; escalation to second-level and external review where available.
05
Prevention reporting
Monthly root-cause report: top denial reasons, upstream owner (front desk / coding / auth), and the fix.
Our goal, stated plainly: shrink our own contingency pipeline. We win when you stop needing us for the same mistake twice, because up to 90% of denials are preventable.4
See it run on your own denials.
15 minutes, a real person, no pitch deck. Or skip the call and sign up online. Prefer to dial? (479) 274-0716
Know your number before you sign anything.
The Recovery Audit is a $500 analysis, yours free, in writing, with an honest go/no-go. Limited slots each month.
Sources
- 1.50–65% of denied claims are NEVER reworked or resubmitted. MGMA
- 2.Fewer than 1% of patients ever appeal a denial. KFF analysis
- 3.Of denied Medicare Advantage claims that ARE appealed, roughly 54–57% get overturned. Federal MA appeals data / KFF
- 4.As many as 86–90% of denials are preventable. Kaiser Family Foundation research