How it works
A small pilot first.
Start with 10 to 20 aged Medicare Advantage denials. You see results before committing to more, and you pay only on what comes back.
Pricing
Pilot
One batch of aged denials, to prove it out
15%of recoveries10 to 20 Medicare Advantage denials you choose
- BAA signed before any patient data
- Every claim sorted by reason, dollar value and deadline
- Appeals, plan disputes and reopenings filed and tracked
- A written summary of what was recovered and why
Ongoing
Your MA denials and underpayments, worked every month
20–25%of recoveriesRate set in writing based on claim age and volume
- Everything in the pilot
- New denials worked before their deadlines
- Underpayments checked against your contract or Medicare rates
- A monthly report of recoveries and denial patterns by plan
If nothing is recovered on a claim, there's no fee for that claim. "Recovered" means money a plan actually pays after our work. Plans pay your practice directly; we invoice our share after the payment shows on your remittance. Commercial and Medicaid claims are quoted case by case.
The steps
Sign a BAA
No patient information changes hands until a Business Associate Agreement is in place.
Pick 10 to 20 denials
Choose aged Medicare Advantage denials. We work inside your systems whenever we can.
We triage and appeal
Sorted by reason, dollar value and deadline, then appealed the way plans review them.
You pay on recoveries
A share of what comes back. If nothing is recovered, there's no fee.
Patient privacy comes first.
Business Associate Agreement before any data, encrypted storage, the minimum information each appeal needs, and no patient data in public AI tools.
Common questions
What does it cost?
A share of what's actually recovered, agreed in writing before any work starts. If nothing is recovered, there's no fee.
Is a Medicare Advantage plan leaving your area in 2027?
Several large insurers are cutting Medicare Advantage plans and counties for 2027. If one of your plans is leaving, work its open denials and underpayments now, while the plan is still staffed to answer them.
Do you work commercial or Medicaid claims?
Medicare Advantage is our focus, because that's where Kevin spent 15+ years on the health plan side. Ask about commercial and Medicaid claims; we'll tell you plainly if they're a fit.
Who does the work?
Kevin, here in Scranton. He spent more than 15 years inside Medicare Advantage claims operations, so he knows why plans deny claims and what gets them paid.
How do you handle patient information?
Nothing changes hands until a Business Associate Agreement is signed. After that we use the minimum information each appeal needs, keep it encrypted, and never put patient data into public AI tools.
Ready to try a pilot?
Call or text Kevin, or send a message. We'll set up a 20-minute conversation, no patient details needed.