Claims recovery for independent specialty practices

You did the work. The payer said no. We get you paid.

Remend recovers the claims you've already written off. No software to install, no upfront cost — we're paid only a share of what we actually put back in your hands.

835 Works inside your existing clearinghouse $0 If we recover nothing, you pay nothing
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CO-197 prior authorization — most-overturned category CO-22 coordination of benefits — mechanical fix, routinely abandoned CO-16 missing claim information — resubmit & recover CO-11 diagnosis inconsistent with procedure CO-4 modifier missing or invalid CO-97 bundled — often separately billable E/M downcodes paid below documented level of service Underpayments paid below your contracted rate — silent, rarely caught
The problem

Most denials are never appealed. Not because they'd lose — because no one is paid to fight them.

No. 01

Denials are automated. Appeals aren't.

Payers deny claims in bulk, by algorithm. Fighting back means a person pulling the chart, writing the letter, and tracking the deadline — one claim at a time. No independent practice staffs for that.

No. 02

Billing companies are paid on collections

A biller earning a percentage of collections makes almost nothing chasing hard denials. Writing them off is rational — for them. The loss is yours.

No. 03

The pile compounds quietly

Each write-off is small. Across a year of claims and every payer you bill, they add up to real money that no one is accountable for recovering.

~0%
of denied Medicare Advantage prior-auth requests are never appealed1
0%
of denied Medicare Advantage claims are ultimately overturned2
$0
your upfront cost — we're paid only on dollars that actually post back to you
What we do

We hunt. We file. You collect.

Found in your remittance data, worked through your existing portals.

The codes we hunt
LIVE FROM YOUR 835 REMITTANCES
rRemend

38 recoverable claims found in your last 90 days of remittances. First appeal already repaid: $412.50.

Denied in March. Paid today.
010203

Runs on what you already have.

No new software, no EHR access, no workflow change. We plug into the remittance data and payer portals you already have.

Free recovery audit
Appeals via your existing portals
One line-itemed contingency invoice
Watch it work

This is the actual product. Not a slideshow.

An autonomous engine reads your denials, drafts grounded appeals, files them, and tracks every dollar — while you watch it happen in a dashboard built for practice owners. Below: the real screens, with illustrative data.

01

Denials come in

Every remittance that hits your clearinghouse gets read the day it lands. Denials — and the silent downcodes a human never catches — drop into one queue. Nothing waits for someone to notice.

02

Every claim gets a play

The engine reads the payer's own denial codes and picks the move: corrected claim, records appeal, downcode dispute, COB fix. Claims that genuinely can't win are closed with the reason written down — not buried in a report.

03

Evidence, pulled — not typed

For each claim it gathers what the appeal actually needs from your EHR, clearinghouse, and payer portals: the remit line, the chart documentation, the auth record, the payer's own policy language.

04

A grounded appeal, drafted

The letter cites the denial code, the documentation, and the payer's reconsideration rules — specific to this claim, not a mail-merge template. Ready in minutes, not on someone's someday list.

05

Filed on the right rail

Payer portal, clearinghouse, or paper — whichever channel this payer actually answers. Deadlines tracked, every submission logged, responses watched until the payer moves.

06

You watch the dollars post

Your dashboard shows every claim — recovered, submitted, in progress, or closed with a reason. No black box, no monthly PDF. Our fee is invoiced on posted cash only, after it's in your account.

app.remendhealth.com ILLUSTRATIVE DATA
remend. Operator
Today
Every claim the machine has worked, in exactly one bucket.
ClaimPayerBalanceDenialPlay
CLM-2381Aetna$412.50CO-197Records appeal
CLM-2384UnitedHealthcare$1,284.00CO-22COB fix
CLM-2390BCBS$655.20CO-16Corrected claim
CLM-2391Cigna$389.4092014→92012Downcode dispute
CLM-2402Humana$208.10CO-45Closed — contractual, not winnable
CLM-2407Aetna$978.65CO-50Records appeal
Reading remittances…
CLM-2381 Aetna · CO-197 prior authorization · $412.50
Gathering the packet — every item cited in the letter.
835 remit lineCARC CO-197 · denial date · billed and allowed amounts
CLEARINGHOUSE
Chart documentationVisit note + imaging for the date of service — medical necessity on record
EHR
Prior-auth recordAuthorization on file, active for the service window
PAYER PORTAL
Payer policyReconsideration allowed with auth evidence — 180-day window, on the clock
POLICY
Appeal — CLM-2381 reconsideration · Aetna
Payer portal Clearinghouse Certified mail DRAFT
Recovery dashboard
Every claim Remend is working for your practice.

Recovered

$011 claims paid

Submitted & watching

27$31,406 · last checked today

In progress with the machine

14$18,972

Waiting on your staff

31 call · 2 postings

Week of July 14

12 appeals filed. Aetna paid CLM-2381 in full — $412.50 posted to your account. 2 downcode disputes went out with the chart attached. 1 claim closed as not winnable, reason on its page. Our fee invoices on posted cash only.

ClaimPayerBalanceStatus
CLM-2381Aetna$412.50Paid in full — posted
CLM-2390BCBS$655.20Corrected claim accepted — watching for the remit
CLM-2402Humana$208.10Closed — contractual write-off, not winnable
100sof appeals drafted and filed by the live engine — measured in the hundreds, growing daily
Minutesper appeal, evidence to filed — the same packet takes a person ~45
$0until recovered dollars actually post to your account
How it works

From written off to recovered.

  • The free audit. Send us — or simply show us — your remittance (835) files and aged A/R. We quantify what's recoverable: payer by payer, code by code.
  • We do the work. We draft and file the appeals — reconsiderations, redeterminations, corrected claims — through your existing payer portals. You approve; nothing changes about how you bill.
  • You're paid first. Recovered dollars post to your practice like any other payment. We invoice a share of what actually posted — terms agreed in writing before we start.
REMITTANCE ADVICE · 835ILLUSTRATIVE
CO-197 · PRIOR AUTHORIZATION
Precert absent — service rendered
$412.50
WRITTEN OFF
CO-22 · COORDINATION OF BENEFITS
Covered by another payer
$1,284.00
WRITTEN OFF
CO-16 · MISSING INFORMATION
Claim lacks required element
$655.20
WRITTEN OFF
CO-45 · CONTRACTUAL
Exceeds fee schedule — not workable
$208.10
DEAD
CO-97 · BUNDLED SERVICE
Separately billable — payer error
$390.75
WRITTEN OFF
RECOVERABLE IN THIS FILE$0.00
The math

What's sitting in your pile?

Specialty
Physicians in your group
8MDs
ESTIMATED RECOVERABLE · PER YEAR
$0$0
MEDICARE FEE-FOR-SERVICE ALONE
Commercial and Medicare Advantage denials come on top of this — they're usually the bigger share, and they only show up in your 835s.
Get your real number — free audit

Estimate method: CMS Medicare Physician & Other Practitioners data (2024) — the typical range (25th–75th percentile) of Medicare allowed dollars per physician in your specialty, multiplied by the share of denied-then-abandoned dollars that is typically recoverable. It is a screening estimate, not a quote; the audit replaces it with a number computed from your actual remittances.

These are claims you've already written off to zero. If we recover nothing, you pay nothing — and you've lost nothing.

— The whole deal

Data & trust

Your data, handled like it's radioactive.

HIPAA Business Associate

We operate as a HIPAA Business Associate and sign a BAA with every practice. No patient-identifiable data moves until it's in place.

De-identified audits

The free audit can run on payer, denial code, amount, and date alone — no patient names required.

Your existing rails

We work inside your current clearinghouse and payer portals. No new software, no EHR access required.

Never sold, never shared

Your claims data is used to recover your money. That's it.

Minimum necessary by design

We send only the data needed to work each claim, and strip identifiers from anything that doesn't require them.

Common questions

Asked by every practice we talk to.

Do I have to leave my billing company?

No. We recover claims that have already been written off — money that's currently going to zero. Your billing company keeps doing what it does; we work the pile they've moved on from.

What do you need from us?

A remittance (835/ERA) export and an aged accounts-receivable report. Most clearinghouses — Availity, Waystar, Office Ally — produce both in minutes, and we'll walk you or your biller through it.

What does it cost?

A share of recovered dollars, agreed in writing before we start. No upfront fee, no subscription, no minimum. If we recover nothing, you owe nothing.

How is this different from my clearinghouse's denial reports?

Reports tell you what was denied. Someone still has to read the codes, find the winnable ones, draft the appeal, file it, and track it to payment. That labor is exactly what doesn't pencil for a busy practice — and it's the entire thing we do.

Find out what you're owed.

Two ways in. Talk to the founder first — or skip straight to the paperwork and let us start from your real denials.

PATH 1

Let's talk

Twenty minutes with Zack — what's in your denial pile, what's recoverable, how the contingency works. No paperwork first.

Or leave your details and Zack will reach out:

Practice, name, and a valid email, please.
Got it — Zack will reply from zack@remendhealth.com, usually same day. Want a time on the calendar now? Book directly.

Prefer email? zack@remendhealth.com

PATH 2

I'm ready

Sign the HIPAA Business Associate Agreement now — five fields, two minutes. Then our first call starts from your actual remittances instead of a pitch. The BAA covers data handling only; it commits you to no fees and no engagement.

  • Read and sign the BAA online
  • We countersign and email your executed copy
  • You send a remittance export; we come back with real numbers

Or email directly: zack@remendhealth.com