Denied-claim recovery for independent practices
Found money for your practice, in the claims you've already written off.
Every month, your clinic writes off a pile of small denials nobody has time to fight: a visit paid at a lower level than you billed, a visit bundled into a procedure, a missing modifier. And you're right to let them go. When fighting a $150 denial takes an hour on hold, writing it off isn't a billing failure. It's arithmetic.
I built a system that changes the math on those write-offs, and I'm looking for three founding clinics to tailor it around.
You send me the claims you've already written off. My system pulls the payer policy, drafts the appeal from the claim, and from the chart note when the argument needs one, and hands you ready-to-file packets. Payers still pay you directly. I invoice 20% of what they pay, afterward, and you keep the other 80%. If I recover nothing, you pay nothing.
What we charge
- 20%
- our founding fee on everything we recover for the first three practices, you keep the other 80%
- $0
- our fee if we recover nothing
The payer pays your practice. We invoice you afterward, for our share only. Standard rate after the founding three: 35% on the first pass, 30% ongoing.
Why I'm building this
Independent medicine is better for patients. The paperwork is just trying to kill it.
Small and mid-sized independent practices are where doctors can actually practice medicine the way it's supposed to be done. Watching clinics get squeezed into selling to hospital systems or private equity is infuriating, especially when it happens not because the medicine failed, but because hiring is impossible, reimbursements are shrinking, and the administrative pile never stops growing.
Large health systems survive that squeeze because they have an army in the back office. A 1-to-10 provider clinic doesn't. You have a lean team doing three jobs at once.
Plenty of small denials win on paper.
The clinical support is already sitting in your chart, and the payer's own published policy allows the payment. The insurance company is just betting you don't have the spare staff hours to pull both and write the appeal.
Revalis exists to take that fight off your desk without giving your staff another piece of software to manage.
How it works
I don't want your budget. I want your reject pile.
Your billing team keeps doing exactly what they do today on active claims. I only touch the denials that have aged past the window you set (typically 90 days) and that your team had to write off.
Sign a BAA and drop one export.
We start with a standard HIPAA Business Associate Agreement. Once signed, someone on your team drops a monthly denial export onto a private, encrypted upload page. No software to install, no IT project, and no EMR integration. Before I touch a single claim, I send you the list of candidates. You cross off anything you don't want worked, for any reason at all.
Your time · ~10 mins / monthI build the appeals; you keep the veto.
The system reads each denial, pulls the payer's published coverage policy, and drafts the appeal from the claim, and from the chart note when the argument needs one. I review every single packet myself before you ever see it. Once a week, you get a clean one-page sheet of finished packets:
- Administrative appeals (missing information, eligibility, technicalities) are built from the denial export alone and don't require your doctor's time.
- Appeals that lean on a chart note flag the exact note needed: typically 5 to 10 a month, more in dermatology, where the visit-plus-procedure appeals cite the note. Only the ones that make a clinical argument carry a line for the clinician's signature.
- Cross off anything you don't want sent. Your team submits the approved packets through your existing payer portals.
Your time · ~30 to 45 mins / monthYour time · ~10 to 15 mins / weekWeekly approval sheet
Sample · synthetic data
Revalis
Weekly approval sheet
Prepared for Example Dermatology Group · released by the practice
Tick to releaseCross off to hold backNothing is submitted until released
Decision Line Claim Payer Denial Type Why it should pay At issue File by 1 ••4733 Payer A CO-97 bundling Coding · chart-supported Note of 11/21/25 documents a separate complaint; payer rule REIMB-014 §3.2 allows both. 168.20 06/02/26 2 ••4741 Payer B CO-16 missing info Administrative Corrected claim adds the referring provider omitted on the original. 112.00 06/16/26 3 ••4756 Payer C CO-50 necessity Clinical Note of 01/14/26 documents failed topical therapy, as payer policy MED-031 requires.Clinician signs below before submission 236.50 07/20/26 4 ••4762 Payer A CO-4 modifier Coding · chart-supported Note of 12/18/25 documents a complaint separate from the destruction; REIMB-014 §3.2 allows both.Crossed off by the practice · not sent 94.00 07/08/26 Released on your tick · administrative and coding · 2 280.20 Released once signed · clinical · 1 236.50 Crossed off · held back · 1 94.00 At issue on this sheet · 4 packets 610.70 Clinician approval · clinical lines only (line 3)
N/A for administrative and coding lines: they assert nothing the record does not already document, so your tick releases them.
Clinician signatureDateYour staff submit released packets through your own payer portals, clearinghouse, or billing system, under your own credentials
Each packet comes complete with its cover sheet, enclosures, filing instructions, and deadlinePayers pay you directly.
Remittance goes straight into your clinic's bank account, the exact way it does today. At the end of the month, you get a plain-English statement showing which claims paid out, and I invoice my 20% only after the money has landed.
What this actually asks of your team
About an hour and a half to two hours a month, plus a couple of minutes to send each packet.
Ten minutes a month for the export, thirty to forty-five minutes a month for notes, and ten to fifteen minutes a week on the sheet. Each row above costs what it says; if one costs you more, the row is wrong and I want to hear about it.
Where the money hides
What's usually sitting in the write-off pile.
Where a denied claim ends up
Industry estimate
Denied claims in a month
Every denial a practice receivesEach one falls on one side of a line
Below the line · the long tail
Worth a person's time · worked
A large share are paid when properly appealedThat block is the only part of the picture Revalis works.
Below the line · the long tail
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.
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.
In Dermatology
The procedure got paid. The visit that day didn't.
The payer reimburses the biopsy or destruction and denies the E/M visit from the same appointment. At $90 to $250 each, nobody has time to fight them one by one, so they quietly drain thousands a month. When appealed with the chart note attached and the payer's own modifier rule cited, they routinely pay.
In Behavioral Health & Specialty Clinics
Downcoded sessions, eligibility gaps, and auth technicalities.
Visits reimbursed as shorter sessions than delivered, or denied over coding and authorization technicalities ($100 to $180 each) that nobody has the bandwidth to chase at the end of a clinical day.
Based on industry denial data for independent practices, a 3 to 5 provider clinic typically has:
In older write-offs
$7,000 to $15,000
sitting in older write-offs that are still inside their 90-to-180-day appeal windows.
Plus, every month
$2,000 to $6,000 a month
in new small denials aging out.
These are estimates from industry data, not a promise about your practice. Your own denial export tells us the real number, before you sign anything beyond a BAA.
No mystery accounting
What lands on your desk each month.
Here is the exact reporting format I built so you never have to guess what worked, what's pending, or what you owe:
Sample monthly recovery statement
Sample · synthetic data
Revalis
Monthly recovery statement
| Claim | DOS | Payer | Denial | Billed | Recovered | Status |
|---|---|---|---|---|---|---|
| ••4471 | 11/04/25 | Payer A | CO-97 bundling | 187.40 | 148.92 | Paid |
| ••4508 | 11/12/25 | Payer A | CO-4 modifier | 243.00 | 201.15 | Paid |
| ••4612 | 12/02/25 | Payer B | CO-16 missing info | 112.25 | 84.30 | Paid |
| ••4655 | 12/09/25 | Payer C | CO-197 no auth | 287.10 | – | Appeal filed |
| Recovered and paid directly to your clinic | 2,847.15 |
| Your share, already paid to you by the payer (80%) | 2,277.72 |
| Revalis founding fee (20% of recovered; standard 35%/30%) | 569.43 |
Fee invoiced only after remittance lands
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.
Founding partner terms
An honest trade for my first three clinics: a flat 20%.
I'm not going to pretend Revalis is a 50-person corporate vendor with a call center. Right now, it's me and the system I've built.
I'm looking for three independent clinics to partner with me as founding practices. If you give me the chance to prove this on your write-off pile and shape the workflow around how your office actually runs, here is what you get in return:
One denied claim, followed through
Illustrative · not a projection for your practice
- DeniedPayer A denied a 99213 visit billed with modifier 25 the same day as a biopsy: CO-4. Written off.$0.00paid to you
- AppealedI build and review the packet. Your team uploads the visit note, ticks the packet on the weekly sheet, and submits it through your own portal or billing system.–
- RecoveredThe payer pays your practice directly.$180.00paid to you
$144.00Your share · 80% · already in your account
$36.00Revalis founding fee · 20%
invoiced afterward
$144.00 + $36.00 = $180.00 recovered
| Rate | You keep | Our fee | |
|---|---|---|---|
| Founding, first three practices | 20% | $144.00 | $36.00 |
| Standard, first pass | 35% | $117.00 | $63.00 |
| Standard, ongoing | 30% | $126.00 | $54.00 |
| If we recover nothing | – | $0.00 | $0.00 |
A flat 20% founding rate, locked for twelve months.
My standard rate is 35% on the first pass and 30% after that. Founding clinics get a flat 20%, locked for twelve months. You keep 80% of money that was otherwise going to zero.
Built around your clinic's actual workflow.
Tell me how your biller likes exports formatted, how your doctors prefer to sign off, and what you never want touched. I will build the system around your habits instead of forcing you into a rigid template.
Direct access to me.
No ticket queues, no account managers reading scripts. You get my cell and my inbox.
Nothing up front.
No setup fee, no software fee, no monthly minimum. After the first pass, no lock-in. If I recover nothing, you pay nothing.
Ground rules
What I will never do.
- Never touch active claims inside your billing team's working window (90 days by default).
- Never touch your money. Payers remit directly to your practice.
- Never send a clinical argument without your clinician's signature.
- Never contact a patient. Not a call, not a letter, nothing.
- Never call a payer. Every appeal goes in writing, and your team sends it.
- Never lock you in. After the first pass (about 6 to 8 weeks), if it isn't the easiest money your practice recovers all year, you can walk away any time.
I review every single packet myself before you ever see it.
Brendan Gamache
Founder, Revalis Solutions LLC
Let's see what's sitting in your write-offs. It costs nothing to find out.
If you're open to seeing what your reject pile is actually worth, we start with two simple things:
1. A mutual HIPAA BAA
Takes 5 minutes and commits you to nothing.
2. One denial export
From your billing system, dropped onto an encrypted upload page.
I'll run a free audit on the export and show you exactly how many of your written-off claims are still inside their appeal windows and recoverable. Either we find real money sitting in your backlog, or we don't. Either way, you'll know your real number before deciding a thing.