Services · Denial & Underpayment Recovery
How to recover denied and underpaid claims
Denied claims and underpaid claims are different problems. A denial is visible it appears on the remit and somebody has to work it before the appeal window closes. An underpayment is invisible, because the claim shows as paid; the payer simply paid less than your contract requires.
Most practices work some denials and catch almost no underpayments. I work both on contingency: a percentage of what I actually recover, no upfront fee. Recovery typically begins within a week of a signed Business Associate Agreement and system access, and most engagements surface recoverable dollars inside the first thirty days.
How it works
- Signed Business Associate Agreement and read-only system access
- I pull 12–24 months of remits and load your contracted fee schedules
- Every paid claim is compared line by line against contracted rates
- Denials are sorted by appeal deadline, dollar value, and likelihood of overturn
- I file appeals and underpayment demands as your authorized representative
- You are invoiced only on money that actually lands
The four leaks I find most
- Timely filing lapses denials nobody worked before the window closed. Unrecoverable, and a signal the process is broken.
- Silent underpayments payment below contracted rate on high-volume codes. Small per claim, large per year.
- Credentialing gaps an enrollment lapsed and claims denied for months before anyone connected the cause.
- Bundling and modifier errors systematic and repeatable, worth fixing at the source rather than one claim at a time.
What it costs
A contingency percentage of recovered dollars, set in writing before work begins. No recovery, no fee.
Who this is not for
Practices already working claims to a sub-4% denial rate with contract-rate variance monitoring in place.
State rules
How far back recovery reaches depends on payer appeal windows and your state's prompt-pay statute, which sets the deadline by which a clean claim must be paid and often carries interest penalties. That statute is leverage. See your state →
FAQ
Questions and answers
Set before work begins and published on the pricing page.
Commonly 12–24 months, sometimes longer for contractual underpayments, depending on payer rules and state law.
Yes, as your authorized representative under a signed agreement.
You owe nothing.
No. Appeals and underpayment demands are routine contract enforcement.
Start with an assessment, not a contract
Two weeks, fixed fee, $2,500 to $5,000 depending on practice size. You get a written finding: where the money is going, what each leak is worth annually, and what it costs to fix. You own that report whether or not you hire me for anything after it.
Start with an assessment