Revalis

Denied-claim recovery for independent practices

Found money for your practice.

We recover the small denied claims that aren't worth anyone's time to fight by hand. The payer pays your practice directly, and we invoice a share of what actually arrives. If we recover nothing, you pay nothing.

What we charge

35%
our fee on the initial backlog sweep — you keep the other 65%
30%
our fee on recoveries after your start date — you keep the other 70%
$0
our fee if we recover nothing

The payer pays your practice. We invoice you afterward, for our share only.

No setup feesNo softwareNo subscriptionsWe never touch your payments

The problem

Every practice has a pile of small denials that cost more to fight than they bring back.

These aren't unwinnable claims. Fighting a $200 denial just costs more in staff time than the claim is worth. MGMA estimates that 50 to 65 percent of denied claims are never reworked, and a large share of the ones that are properly appealed get paid. That gap is real money sitting in your write-offs.

Where a denied claim ends up

Industry estimate

Denied claims in a month

Every denial a practice receives

Each one falls on one side of a line

Worth a person's time · worked
Below the line · the long tail

MGMA estimates that 50 to 65 percent of denied claims are never reworked. That figure is industry-wide and says nothing about any one practice. It is arithmetic: under a certain dollar value, a manual appeal costs more staff time than the claim returns.

Inside that long tail:

A large share are paid when properly appealed

That block is the only part of the picture Revalis works.

Proportions in this figure are illustrative; the labels are the claim, not the widths. Figures reflect published industry denial data for professional claims and are not a projection for your practice. Your own denial report tells us your real number.

Your billers aren't doing anything wrong. The math just doesn't work for a human. We built a system where it does.

Every practice has a long tail of small denials that would cost more to fight than they'd bring back. That is not a failure of your billing team. It is arithmetic.

Your team keeps everything current and works the claims worth working. We take only the denials below the line, where manual effort stops making sense. Their queue stays their queue, and we never open a claim someone there has open.

How it works

What your team does, and what we do.

1

Sign once.

A standard HIPAA Business Associate Agreement, the routine legal step that lets us look at your data at all, plus a short service agreement.

Your time · about 15 minutes, once

2

Send us the report, then notes for the claims we flag.

We send you a private, encrypted upload page. Your team drops in the denial report you already run, and, only for the specific claims we flag, the supporting notes.

  • No software to install
  • No login for your team to manage
  • No access to your EMR, ever
  • Files go straight to encrypted storage
3

Get a check and a statement.

Payers pay you directly, exactly as they do today. Each month you get a plain-English statement of what we recovered, and we invoice our share only after you have been paid.

Your time · none

What happens between those steps

We read each denial, pull the payer's own published rules, and build the appeal from what is already in the chart. AI does the reading and the drafting, which is what makes claims this small worth working at all. A person reviews every packet before it leaves, and it is filed on paper or through the portal exactly the way any biller would file it.

Anything that makes a clinical argument goes to your clinician first, never claim by claim, but as one short weekly batch they approve in a single sitting. Most appeals are administrative and need no clinical sign-off at all.

Your part

Our part

Sign two documents.

A mutual BAA and a short service agreement, both of which arrive already filled in.

Your time · About 15 minutes, once

We draft both and send them to you.

Nothing moves, and no data is requested, until they come back signed.

Send the denial report you already run.

Drop it on the private, encrypted page we send you, then close the tab. There is no new report to build and no format to match.

Your time · About 10 minutes a month

We read every denial on it.

For each one we pull the payer's own published policy for that code and check it against what the chart already documents. Then we come back with the candidate list, and you strike anything you want struck.

Pull notes for the claims we flag as clinical.

We name the specific claims and the specific notes. Typically 5 to 10 claims a month for a practice your size.

Your time · About 30 to 45 minutes a month

Most appeals never reach you at all.

Bundling, modifiers, eligibility, authorization technicalities: the majority of the volume is administrative, and administrative appeals are built from the denial report and the claim data alone. Those never ask you for a note.

Approve the weekly clinical sheet.

One page listing each appeal's claim, the argument being made, and the chart basis for it. Your clinician signs the sheet in a single sitting, whenever suits them.

Your time · A few minutes of your clinician's week

We assemble the sheet and hold the packets.

Every packet that makes a clinical argument waits until that signature comes back. Plenty of weeks have nothing clinical in them, and in those weeks no sheet arrives.

Deposit the payer's checks.

Payers pay your practice directly, into the same account they use today. Nothing about your remittance changes.

Your time · None

We file, track, report, and invoice last.

A person reviews every packet before it leaves. We file it on paper or through the portal, track the deadline, send you a monthly statement, and invoice our share only after the payer has paid you.

Your total

About ten minutes for the report, thirty to forty-five minutes of notes, and the odd question in between. An hour or two a month. That figure is the sum of the rows above and nothing else; if a row costs you more than it says, the total is wrong and we want to hear about it.

What lands on your desk each month

Sample · synthetic data
SAMPLE

Revalis

Monthly recovery statement

Practice · Cedar Ridge Dermatology
Period · March 2026
Statement · SAMPLE-0000
ClaimDOSPayerDenialBilledRecoveredStatus
••447111/04/25Payer ACO-97 bundling187.40187.40Paid
••450811/12/25Payer ACO-4 modifier243.00243.00Paid
••461212/02/25Payer BCO-16 missing info112.25112.25Paid
••465512/09/25Payer CCO-197 no auth287.10Appeal filed
Recovered and posted to you2,847.15
Your share, already paid to you by the payer1,850.65
Revalis fee · 35% of recovered996.50
Invoiced this month996.50
Four of 38 lines shown · Payers remit directly to the practice · Revalis never receives funds
Invoiced only after the payer has paid you

Illustrative format only. Synthetic practice, synthetic claims, payers shown as A/B/C. Revalis has no client records to publish, so this shows what the reporting looks like, not what anyone earned.

See the sample statement and a sample appeal packet →

Where the money usually is

What this actually recovers.

Dermatology practices

Multi-procedure visits denied on modifier and bundling grounds.

The classic write-off: individually too small to fight, collectively thousands a month. These are precisely the denials that win on paper when someone finally builds the case from the chart.

Behavioral-health groups

Session claims denied for authorization, eligibility, or coding technicalities.

They pile up fastest when clinicians bill for themselves. Each one is an hour of your work someone declined to pay for, and most are recoverable with a properly documented resubmission.

The numbers

What a practice your size might be sitting on.

For a typical 3–5 provider practice, industry denial data puts it here:

First backlog sweep · one time

$7,000–$15,000

Recovered from write-offs still inside their appeal windows. Most payers allow 90 to 180 days from the remittance date, so a sweep reaches the recent past rather than the whole history. Anything past its window can no longer be appealed by us or by anyone else, which is what keeps this number where it is.

Ongoing · per month

$2,000–$6,000

From long-tail denials worked as they occur, once the sweep is done. Nothing ages out while we are on it, which is why the monthly figure is not capped by an appeal window the way the sweep is.

These are estimates from industry data, not promises. Your own denial report tells us the real number, before you sign anything beyond a BAA.

Pricing

What we charge.

This is the entire fee schedule. There are no other charges of any kind.

35%

Our fee on the initial backlog sweep

Everything already denied and written off as of your start date that is still inside its appeal window. One pass through history.

30%

Our fee on everything after that

New denials that reach the long tail after your start date.

The line between the two is your start date, fixed in the agreement. No reclassification.

$0

If we recover nothing

No setup fees, no software, no subscriptions, no minimums.

We invoice after the payer has paid you, never before. Cancel any time after the initial sweep, which runs about six to eight weeks.

Boundaries

What we will never do.

  • Touch claims your team is actively working
  • Call your payers or escalate anything by phone
  • Receive or handle your payments
  • Send a clinical argument without your clinician's sign-off
  • Lock you in. The only commitment is the initial sweep itself, which runs about six to eight weeks; after that, cancel any time, with no notice period and no fee.
Signed BAAEncrypted in transit and at restMinimum-necessary accessComplete audit trailA human reviews every packetSecurity & compliance →

The next step costs nothing.

We will show you the recoverable number sitting in your write-offs. Here is everything it takes.

Two things:

A mutual BAA

The standard HIPAA formality that makes it legal for us to look at your numbers. It protects you; it commits you to nothing.

Your denial report

The one you already run, dropped on a secure page.

That is it. We will show you exactly how much recoverable money is sitting in your write-offs, before you sign anything else.