Hospitals quietly lose 1–3% of net patient revenue to underpayment, denials, and unworked appeals. We find it and bring it home.
Book a walkthrough See how ↓to underpayment, eligibility denials, and appeals no one had time to work: revenue you earned but never collected.
brought back and returned to your bottom line. Money that was always yours.
We read what your RCM already produces and return verified, recovered revenue into the same workflow. Live in weeks, not years.
Claims, remittances, and contracts flow in from the EHR and billing systems you already run: EDI 835/837, UB-04, FHIR.
Agents verify eligibility, match every payment against contracted rates, score denials, and draft appeals, with human review on edge cases.
Verified results, filed appeals, and recovered dollars land back in your existing workflow. No new system to learn.
Verify eligibility and authorization before a claim is ever generated, not after it comes back denied.
Cross-check every remittance against the contract that governs it, automatically, in real time.
Draft contract-cited appeals and pursue unworked balances at a scale no back office can match by hand.
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Every payer contract read, classified, and turned into a live rate engine.
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Phone and portal agents verify coverage before the visit.
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Appealability scored, appeals drafted with contract citations.
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Calls payers on unresolved claims and logs every outcome.
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Modifier errors and uncoded diagnoses caught before submission.
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Type a question, get a dashboard. Every answer shows its source.
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annual value for a mid-size hospital: eligibility, contract analytics, and appeals combined, year one.
Cited industry benchmarks next to what our hospitals actually see. Replace the figures with your own sourced data.
| Metric | Industry average | With us |
|---|---|---|
| Initial claim denial rate | 11.6% averagePublished benchmark, 2025 | 25–40% fewer denials within 90 daysPilot data |
| Net revenue lost to denials | 4.8% of net patient revenueIndustry survey | 35–55% of identified underpayment recovered in 6–12 monthsDeployment data |
| Cost to rework one denied claim | $25–$118 per claimIndustry press | Appeal drafted in 20–30 minutes, down from 3–4 hoursPilot deployments |
| Eligibility check time | 3–5 minutes per check, manualManual portal / phone workflow | ~41 seconds, fully automatedDeployment data |
Industry figures are third-party published benchmarks, cited above.
Send one month of remits and your top three contracts. We’ll return the number. It’s yours either way.