Denied-claim recovery for independent practices
Found money for your practice.
Somewhere in your billing system there's a list of denials nobody has time to fight: a visit the insurer decided was a shorter visit, a procedure they bundled into another one, each worth less than the time it takes to argue for it. We work that list and nothing else. The insurer keeps paying you exactly the way they do now. We invoice afterward, for our share of what actually arrived, and nothing if nothing did.
What we charge
- 35%
- our fee on the first sweep, and you keep the other 65%
- 30%
- our fee on recoveries after your start date, and you keep the other 70%
- $0
- our fee if we recover nothing
The insurer pays your practice. We invoice you afterward, for our share only.
The problem
Every practice has a pile of small denials that cost more to fight than they bring back.
These aren't unwinnable claims. Most of them win on paper, from the insurer's own published rules and what your chart already says. Fighting a $200 denial costs more than $200 in staff time. The insurer knows that. MGMA estimates that 50 to 65 percent of denied claims are never reworked. That's not a billing failure. It's the only sane call, made over and over, and the money is still sitting in your write-offs.
Where a denied claim ends up
Industry estimateDenied claims in a month
Each one falls on one side of a line
MGMA estimates that 50 to 65 percent of denied claims are never reworked. That figure is industry-wide and says nothing about any one practice. It is arithmetic: under a certain dollar value, a manual appeal costs more staff time than the claim returns.
Inside that long tail:
That block is the only part of the picture Revalis works.
Proportions in this figure are illustrative; the labels are the claim, not the widths. Figures reflect published industry denial data for professional claims and are not a projection for your practice. Your own denial export tells us your real number.
Your billers aren't doing anything wrong. The math just doesn't work for a human. We built a system where it does.
When a claim costs more in staff time to appeal than it's worth, writing it off is smart triage, not failure. That's the right call, and anyone who says otherwise has never done their own billing at 11pm.
Your team keeps everything current and works the claims worth working. We work a different set of claims than they do, and we never touch theirs: nothing with any activity inside the window you set, and nothing you've crossed off the list.
How it works
What your team does, and what we do.
Sign once.
A standard HIPAA Business Associate Agreement, the routine paperwork that makes it legal for us to look at your numbers at all, plus a short service agreement. Both protect you. Neither commits you to anything.
Your time · about 15 minutes, once
Send the export, then notes for the claims we flag.
We send you a private, encrypted upload page. Your team drops your denial export on it and closes the tab. Later, and only for the specific claims we flag, the supporting notes go up the same way.
- No software to install
- No login for your team to manage
- No access to your EMR, ever
- Files go straight to encrypted storage
Get paid the way you already get paid.
The insurer pays you directly, exactly as they do today. Nothing about your remittance changes. Each month you get a plain-English statement of what came back, and we invoice our share only after you have been paid.
What happens between those steps
We read each denial, pull the insurer's own published rule for it, and build the appeal from what is already in the chart. AI does the reading and the drafting, which is the only reason a claim this small is worth anyone's time. A person reads every packet before it leaves (right now that person is me), and it is filed on paper or through the portal exactly the way any biller would file it.
Every packet goes on a one-page weekly sheet you tick before anything files. Anything that makes a clinical argument gets your clinician's signature on the same sheet, never claim by claim. Most appeals are administrative and need no clinical signature at all.
Your part
Our part
Sign two documents.
A mutual BAA and a short service agreement, both of which arrive already filled in.
Your time · About 15 minutes, once
We draft both and send them to you.
Nothing moves, and no data is requested, until they come back signed.
Send the monthly denial export.
Drop it on the private, encrypted page we send you, then close the tab. There is no format to match and no fields to fill in.
Your time · About 10 minutes a month
We read every denial on it.
For each one we pull the insurer's own published rule and check it against what the chart already says. Then we come back with the candidate list, and you cross off anything you want crossed off.
Pull notes for the claims we flag as clinical.
We name the specific claims and the specific notes. Typically 5 to 10 claims a month for a practice your size.
Your time · About 30 to 45 minutes a month
Most appeals never reach you at all.
Bundling, modifiers, eligibility, authorization technicalities: the majority of the volume is administrative, and administrative appeals are built from the denial export and the claim data alone. Those never ask you for a note.
Tick the weekly sheet.
One page listing what we're about to file, one line of argument each, and which notes we need. Cross off what doesn't go, no reason needed. Your clinician signs the clinical lines on the same sheet.
Your time · 10 to 15 minutes a week, a few of them your clinician's
We hold every packet until it's ticked.
Nothing goes to an insurer that isn't ticked on that page, and anything clinical waits for the signature as well. Weeks with nothing to file have no sheet.
Deposit the insurer's checks.
The insurer pays your practice directly, into the same account they use today. Nothing about your remittance changes.
Your time · None
We file, track, report, and invoice last.
Every appeal is read by a person before it leaves. We file it on paper or through the portal, track the deadline, send you a monthly statement, and invoice our share only after the insurer has paid you.
Your total
About ten minutes for the export, ten to fifteen minutes a week on the sheet, thirty to forty-five minutes of notes, and the odd question in between. An hour or two a month. That figure is the sum of the rows above and nothing else; if a row costs you more than it says, the total is wrong and we want to hear about it.
What lands on your desk each month
Sample · synthetic dataRevalis
Monthly recovery statement
| Claim | DOS | Payer | Denial | Billed | Recovered | Status |
|---|---|---|---|---|---|---|
| ••4471 | 11/04/25 | Payer A | CO-97 bundling | 187.40 | 187.40 | Paid |
| ••4508 | 11/12/25 | Payer A | CO-4 modifier | 243.00 | 243.00 | Paid |
| ••4612 | 12/02/25 | Payer B | CO-16 missing info | 112.25 | 112.25 | Paid |
| ••4655 | 12/09/25 | Payer C | CO-197 no auth | 287.10 | — | Appeal filed |
| Recovered and posted to you | 2,847.15 |
| Your share, already paid to you by the payer | 1,850.65 |
| Revalis fee · 35% of recovered | 996.50 |
| Invoiced this month | 996.50 |
Invoiced only after the payer has paid you
Illustrative format only. Synthetic practice, synthetic claims, payers shown as A/B/C. Revalis has no client records to publish, so this shows what the reporting looks like, not what anyone earned.
Where the money usually is
What this actually recovers.
Dermatology practices
The insurer paid for the procedure and denied the visit you did in the same appointment.
Then bundled both into one line. $90–250 each: individually not worth anyone's hour, collectively thousands a month. They win on paper, from the chart, when someone finally builds the case.
Behavioral-health groups
Sessions the insurer paid as a shorter session than you delivered, or decided were the wrong kind of visit.
$104–165 each. They pile up fastest when the clinician is also the billing department. Most are recoverable from the claim line and the insurer's own rules; the ones that aren't, you'll see listed with the reason.
The numbers
What a practice your size might be sitting on.
For a typical 3–5 provider practice, industry denial data puts it here:
First sweep · one time
$7,000–$15,000
Recovered from write-offs still inside their appeal windows. Insurer deadlines run from 60 days to 12 months, most of them 90 to 180 days from the remittance date, so a sweep reaches the recent past rather than the whole history. Anything past its window can no longer be appealed, by us or by anyone else, which is what keeps this number where it is.
Ongoing · per month
$2,000–$6,000
From long-tail denials worked as they occur, once the sweep is done. Nothing ages out while we are on it, which is why the monthly figure isn't capped by an appeal window the way the sweep is.
Pricing
What we charge.
This is the whole of it. There is no page two.
35%
Our fee on the first sweep
Everything already denied and written off as of your start date that is still inside its appeal window. One pass through history.
35% is more than most denial vendors quote, and I'd rather say why than hope you don't notice: it's 35% of claims you'd already written off to zero, on appeals you okay one by one.
30%
Our fee on everything after that
New denials that reach the long tail after your start date.
$0
If we recover nothing
No setup fees, no software, no subscriptions, no minimums.
Boundaries
What we will never do.
- Touch a claim with any activity inside the window you set (90 days unless you say otherwise)
- Call your insurers or escalate anything by phone
- Receive or handle your payments
- Send a clinical argument without your clinician's sign-off
- Contact a patient. Not a call, not a letter, nothing.
- Lock you in. The only commitment is the first sweep itself, about six to eight weeks. After that, cancel any time. No notice period, no fee, no “wind-down” clause.
The next step costs nothing.
We will show you the recoverable number sitting in your write-offs. Here is everything it takes.
Two things:
A mutual BAA
The standard HIPAA formality that makes it legal for us to look at your numbers. It protects you. It commits you to nothing.
Your denial export
Whatever your system prints, dropped on a private, encrypted page.
That's it. Either we find money you'd already written off, or we find nothing and you've spent fifteen minutes on a BAA. Either way you'll know the number before you sign anything else.
Three practices to start. That's what my hours hold when I'm the one reading every packet.