How it works
Exactly what happens, step by step.
This is the whole mechanism: how your data reaches us, what we build with it, who signs what, and when money moves.
01
The report you already run.
Every practice management system produces a denial or rejection report, the one your biller pulls to see what came back unpaid. That report is our entire starting point. Claim number, date of service, payer, denial code, billed amount, status. No new report to build, no format to match, no fields to fill in.
From it we identify the long tail: the small-dollar denials still inside their appeal windows where a manual appeal would cost more than the claim brings back. We come back to you with that as a candidate list, before anything is filed. You strike whatever you want struck, for any reason or none, and we work what is left.
02
A private, encrypted upload page.
We send you a link. It's a private, encrypted page that belongs to your practice. There's no application to install, no integration to set up, and no credentials for anyone to manage. Your team drags the denial report onto it and closes the tab. Files travel from the browser straight into encrypted storage.
When we have reviewed the report, we come back with the specific claims we intend to appeal and the supporting notes each one needs. Those go up the same way. That is the entire data relationship: the minimum necessary, and nothing beyond it.
- No access to your EMR or PM system
- No software installed anywhere
- No logins for your staff to keep track of
- Notes only for the claims we flag
03
How each appeal gets built.
Our system reads the denial, pulls the payer's own published policy for that code, and compares both against what is already documented in the chart. Where the claim is recoverable, it drafts either a corrected claim or a documented appeal, citing the payer's rule, the chart language that satisfies it, and nothing that is not in your records.
AI does the reading and the drafting, which is what makes claims this small economical to work at all. It isn't the last step: A person reviews every packet against the chart and the payer policy before it is filed, on paper or through the portal, exactly the way a biller would file it. We never phone a payer, and we never escalate by voice.
04
Clinical sign-off: one short weekly batch.
Most of what we file is administrative: bundling, modifiers, eligibility, authorization technicalities. None of it needs clinician involvement at all. When an appeal does make a clinical argument, your clinician approves it before it's filed, every time.
Your clinicians are never asked to sign off one claim at a time.
Clinical sign-offs arrive as one short weekly batch: a single page listing each appeal's claim, the argument being made, and the chart basis for it, approved together in one sitting, at whatever time your clinician chooses.
A few minutes a week, and plenty of weeks have nothing clinical in them at all. In those weeks nothing arrives.
05
The monthly rhythm.
Payers pay your practice directly, into the same account they use today. Nothing about your remittance changes, and Revalis never appears between you and your money.
Each month you get a plain-English statement: every claim we worked, what it was denied for, what came back, and what is still open. Then we invoice our share, after the payer has paid you, never before, and never out of the payment itself.
06
Cancelling.
Cancel any time after the initial sweep, which runs about six to eight weeks. We stop filing, hand back a final statement showing everything still in flight, and return or destroy the data we hold per the BAA. Claims already filed and later paid are invoiced at the same rate; nothing else follows you.
The burden, row by row
Your part, and ours.
Every claim anyone makes about how little work this is should be checkable. Here is the whole of it, with what each row costs you stated on the row itself.
Your part
Our part
Sign two documents.
A mutual BAA and a short service agreement, both of which arrive already filled in.
The BAA is the standard HIPAA formality that makes it legal for us to look at your numbers. It protects you and commits you to nothing.
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 denial report you already run.
Drop it on the private, encrypted page we send you, then close the tab. There is no new report to build and no format to match.
Claim number, date of service, payer, denial code, billed amount, status. Whatever your system already prints is what we want.
Your time · About 10 minutes a month
We read every denial on it.
For each one we pull the payer's own published policy for that code and check it against what the chart already documents. Then we come back with the candidate list, and you strike anything you want struck.
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.
Only the portion of the note that supports the appeal. We never ask for a full chart export, and we never ask about a patient whose claim we aren't working.
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 report and the claim data alone. Those never ask you for a note.
Approve the weekly clinical sheet.
One page listing each appeal's claim, the argument being made, and the chart basis for it. Your clinician signs the sheet in a single sitting, whenever suits them.
Your time · A few minutes of your clinician's week
We assemble the sheet and hold the packets.
Every packet that makes a clinical argument waits until that signature comes back. Plenty of weeks have nothing clinical in them, and in those weeks no sheet arrives.
Deposit the payer's checks.
Payers pay 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.
A person reviews every packet 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 payer has paid you.
Your total
About ten minutes for the report, 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 goes out under your name
Every packet has a cover sheet. Here's one.
A person reads every packet before it goes out, and your clinician signs this page before anything clinical does.
Appeal packet · cover sheet
Sample · synthetic dataRevalis
Appeal of denied claim
Prepared for Cedar Ridge Dermatology · filed by the practice
Patient
REDACTED — SAMPLE
Claim number
••••4508
Date of service
11/12/2025
Payer
Payer A
Denial code
CO-4 · modifier inconsistent with procedure
Billed / at issue
$243.00
Appeal deadline
05/28/2026 · 180 days from remittance (29 Nov 2025)
Argument type
ADMINISTRATIVE — CODING
Basis of appeal
Procedure billed with modifier 25 on the same date as a separately identifiable E/M service. Payer medical policy REIMB-014 (rev. 09/2025), section 3.2, permits separate reimbursement where the E/M service is significant and separately identifiable. Chart note of 11/12/2025 documents an unrelated presenting complaint, independent history, exam, and assessment. Requesting reprocessing under the payer's own published policy. No new clinical assertion is made beyond what the record already documents.
Enclosures
1Payer appeal form, completed
2Original claim and remittance advice
3Office note, 11/12/2025 (minimum necessary excerpt)
4Payer policy REIMB-014 §3.2, printed with revision date
Clinician approval — required before filing
This packet is held until the treating clinician approves it in the weekly sign-off batch. Administrative appeals with no clinical assertion are marked N/A and filed on review.
Filed by the practice, on the practice's letterhead · Revalis does not contact payers by telephone
Audit trail reference SAMPLE-0000-A · retained for the life of the engagement
Illustrative format only. Synthetic practice, synthetic claim, payer shown as “Payer A,” policy number invented for the example. Revalis has no client records to publish, so this shows the shape of the work product, not anyone's actual appeal.
What lands on your desk each month
The statement, in full.
One page, plain English, every claim accounted for, including the ones that did not come back.
Monthly recovery statement
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 |
| ••4530 | 11/19/25 | Payer B | CO-45 fee schedule | 126.80 | 126.80 | Paid |
| ••4612 | 12/02/25 | Payer B | CO-16 missing info | 112.25 | 112.25 | Paid |
| ••4638 | 12/05/25 | Payer C | CO-11 dx mismatch | 198.55 | 198.55 | Paid |
| ••4655 | 12/09/25 | Payer C | CO-197 no auth | 287.10 | — | Appeal filed |
| ••4702 | 12/17/25 | Payer A | CO-151 frequency | 154.00 | — | Not recoverable |
| Claims worked this period | 38 |
| Recovered and posted to you | 2,847.15 |
| Still open with payers | 1,204.60 |
| 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 · Full line detail and audit trail available on request
Illustrative format only. Synthetic practice, synthetic claims, payers shown as A/B/C. Dollar figures are examples of the claim sizes this service works, not a projection of what any practice will recover.
Questions
The things practices actually ask.
What does this mean for our biller, or our billing company?
Nothing changes for them. We work only the small-dollar denials below the line where a manual appeal costs more than it returns. Your team keeps everything current and keeps working the claims worth working.
Your billers aren't doing anything wrong. The math just doesn't work for a human. We built a system where it does. We work a different set of claims than they do, and we never touch theirs.
Which claims qualify?
Small-dollar denials, roughly the $100–300 band, still inside their appeal windows. Primarily commercial payers.
We triage the report and come back with a candidate list before we touch anything. You strike whatever you want struck, for any reason or none: a claim your team is already on, a payer relationship you would rather not test, a patient whose history you know. We work only what survives that pass.
How do you get paid?
We invoice after the payer has paid you. Our fee is 35% of what we recover in the initial backlog sweep and 30% of what we recover after your start date. You keep the rest. If we recover nothing, there is no fee.
We never receive or handle your funds. Payers remit directly to your practice, exactly as they do today.
How long does any of this take?
The initial sweep runs about six to eight weeks. It goes out in batches rather than all at once, so the first appeals are filed well before the last ones are built.
Payers then adjudicate on their own clock, typically 30 to 60 days. The first money usually posts to your account about two months after the first filing. After the sweep, new denials are worked on the same monthly rhythm as they occur.
Do you contact our payers by phone?
Never. Every appeal is a documented, written submission built from your own records and the payer's own published policy, filed on paper or through the portal. No one calls anyone on your behalf, and no one escalates by voice.
Do you use AI?
Yes, and here is exactly where: AI reads every denial and drafts every appeal. That is what makes a $180 claim worth working at all, because a human doing it by hand costs more than the claim returns.
A person reviews every packet before it goes anywhere, and your clinician signs anything that makes a clinical argument. The AI doesn't file anything, doesn't contact payers, and doesn't sign anything.
Is our data used to train AI models?
No, never. Not our models, and not a vendor's. Your data is used to work your claims. That is the entire permitted purpose, and it is written into the BAA. See the full security page →
Could this get us audited?
Nothing we file is a new claim or a new clinical assertion. Every appeal argues from the payer's own published policy and from what your chart already documents, on the payer's own appeal form, under your practice's name. Appealing a denial is the ordinary, expected use of a process payers built and staff themselves.
What draws scrutiny is a different thing entirely: upcoding, documentation changed after the fact, or a clinical argument the record does not support. We do none of those, which is why a person checks every packet against the chart before it is filed and your clinician signs anything clinical. Where a claim is not supported, we mark it not recoverable and leave it alone.
How much staff time does this take?
An hour or two a month, and the ledger above breaks that into its parts: roughly ten minutes to send the report, thirty to forty-five minutes pulling notes for the clinical claims we flag, and a few minutes of your clinician's week in the weeks that have anything clinical in them.
Can we cancel?
Any time after the initial sweep, which runs about six to eight weeks. No notice period, no termination fee, and no clause that keeps us working your claims after you have said stop.
What's the catch?
We are early. We are onboarding our first practices, which is why the terms are this good and why you will get more attention than any vendor you have worked with.
What you are risking is an hour or two of staff time a month. There is no fee, no software, no subscription, and no money changes hands unless a payer pays you first.
Who do you work with?
Independent practices, typically 3–5 providers, billing commercial insurance. Currently dermatology and behavioral-health groups. If you are outside that and the math still looks right, say so and we will tell you honestly whether it is worth your time.
The next step costs nothing.
Two things: a mutual BAA, which is the standard HIPAA paperwork that makes it legal for us to look at your numbers, and the denial report you already run.