Claims & revenue administration · Serving independent clinics nationwide · Based in Las Vegas, Nevada

Recover the denied claims already on your books.

11.8%

claims initially denied

Kodiak Solutions, 2024

65%

never resubmitted

MGMA/AHA

4.8%

of net revenue lost to denials

HFMA Pulse Survey

We work the backlog of denied and unpaid claims for services your independent pain, spine, orthopedic, or outpatient imaging clinic has already provided, with prior-authorization denial appeals included. We work alongside your current biller or billing company; we do not replace them. We only take the backlog denials they don't have time to fight. Fees are a percentage of what the payer actually pays on recovered claims. If nothing is recovered, there is no fee.

Fees

If nothing is recovered, there is no fee.

Your biller

We work alongside your current biller; we do not replace them.

How it works

Four clear steps from backlog selection to recovery, with payment only on results.

  1. 1

    You or your biller choose the backlog

    Older denied or unpaid claims your billing team has set aside, including prior-authorization denials for injections, advanced imaging, surgery, or a stimulator. Your biller keeps everything else. We do not log into your payer portals.

  2. 2

    We review and draft from the record

    A person reviews each claim against the denial and the chart, then drafts the appeal or corrected follow-up. If the record does not support an appeal, we say so.

  3. 3

    Your physician signs, and you submit

    The letter goes out on your letterhead, through your staff. We do not make the peer-to-peer call.

  4. 4

    Fees only on recovered payments

    Our fee is a percentage of what the payer actually pays on claims we worked. If nothing is recovered, there is no fee.

Prior-authorization data · Medicare Advantage, 2024

11.5%

of prior-authorization denials were appealed. Of the appeals, 80.7% were fully or partially overturned.

KFF's 28 January 2026 analysis of CMS Part C organization-determination files, all services combined. This figure covers prior-authorization decisions only, not post-service claim denials. KFF notes that CMS does not publish this file by service or specialty. This is not a pain, orthopedic, or imaging rate, and it is not a prediction for your clinic.

KFF, 28 Jan 2026

What stays on your side of the door

Before any chart

  • HIPAA-conscious handling, with a business associate agreement (BAA) signed before any PHI is shared.
  • No names, member IDs, dates of birth, or denial letters on this website, by text, or in a first email.
  • The physician remains the author of anything that is submitted.

This is not

  • A care provider or a peer-to-peer service.
  • Initial prior-authorization requests, coding, or day-to-day billing. Those stay with your current biller.
  • Hospital or large-system claim work.
  • A promise that a denial will be paid. The national figure above is not your overturn or recovery rate.

Contact

Please do not email patient details. A signed BAA and agreed secure sharing process come first.

Sources

  1. Initial denial rate (11.8%, 2024): Kodiak Solutions data, cited in HFMA Battle of the Bots intensifies over healthcare denials (2025). hfma.org/revenue-cycle/denials-management/battle-of-the-bots-intensifies-over-denials/
  2. Denials never resubmitted (65%): MGMA/AHA industry data, cited in HFMA presentation materials. hfma.org/wp-content/uploads/2022/10/denialsmanagementthedevilisinthedetailsnotgeorgia-iowa.pdf
  3. Net revenue lost to denials (4.8%): HFMA Pulse Survey, cited in Redesigning denials management in the OBBBA era (2025). hfma.org/revenue-cycle/redesigning-denials-management-in-the-obbba-era/
  4. Prior-authorization appeals overturn rate (80.7%, Medicare Advantage 2024): KFF analysis of CMS data, 28 January 2026. kff.org/medicare/medicare-advantage-insurers-made-nearly-53-million-prior-authorization-determinations-in-2024/