The claims you wrote off are still owed to you.
Every practice has a pile of denied, underpaid, and aged claims that were never worth the labor to chase. Prexisio works that pile on contingency. You send one file your billing system already exports. We recover what can be recovered. You pay a percentage of what actually comes back, and nothing if nothing does.
Nothing about how your team works has to change.
One file in. A statement out.
The same AR or denial export your practice management system already produces. Messy headers are fine. No integration, no software to install.
A prediction engine trained on your own claims determines which claims will actually pay. A person reviews every decision and every letter before anything reaches a payer.
Every payment is reconciled against the remittance. Your statement shows gross recovered, our fee, and your net. If nothing is recovered, you owe nothing.
Humans review everything payer-facing. The prediction engine proposes, drafts, and organizes. It does not send.
The math on small claims was broken.It is not anymore.
A claim gets denied or underpaid. Someone has to sit on hold to fix it. By the time they do, the labor costs more than the claim is worth. So it gets written off. Not because the money is not owed. Because chasing it never penciled.
Multiply that decision across every payer and every month and it becomes a standing policy nobody chose on purpose: below a certain balance, the payer keeps the money.
Prexisio changes the math from the other side. Before anyone touches a claim, a prediction engine trained on your own claims history determines which ones will actually pay. Your staff never sits on hold for a claim that was never coming back, and the claims worth working get worked with the letter already drafted.
Denied claims
Authorization failures, missing information, coding disputes. Many have a defined path back to payment. We find the ones that do.
Underpaid claims
Paid, but below your contracted rate. The shortfall hides inside remittance data. We compare what was paid against what your contract says and pursue the difference.
Aged claims
Submitted and never resolved. No denial, no payment, no answer. The claims that fell off the follow-up list. We put them back on one.
One file in. A statement out. Humans review everything in between.
Send the file
The same AR or denial export your practice management system already produces. Messy headers are fine. We built for real exports, not perfect ones.
No integration, no software to install, no new logins for your team.
We triage, then we work
The prediction engine reviews every claim and tells you, in plain language, which claims we will work, which we will not, and the reason for each. A person reviews every decision and every letter before anything reaches a payer.
You can see the activity log for any claim at any time.
Money posts, statement issues
When a payer pays, the payment is reconciled against the remittance, the contingency fee is calculated, and your statement shows gross recovered, our fee, and your net.
You can export it any time. If nothing is recovered, there is no statement because there is no fee.
Transparency is not a promise here. It is the product.
Two artifacts define the relationship: the triage decision that tells you what will be worked and why, and the statement that proves every dollar. This is what they look like.
Illustrative example. Not client data. The contingency rate is agreed per placement before work begins.
Triage decision, claim by claim
Claim 20481 · Commercial payer · CPT 64483 · $412.00 open
Accepted for work- This payer historically pays this procedure on follow-up.
- Denied CO-197, authorization absent. A defined reconsideration path exists.
- Within the appeal window.
Planned action: work the authorization path and request reconsideration.
Claim 20495 · Commercial payer · $88.00 open
Declined, with reasonAppeal rights have expired for this claim. We decline it up front, because you should never pay anyone to chase money that is gone.
The statement, to the penny
Every payment is reconciled against the remittance before it appears here. The fee is calculated on recovered dollars only. If a payment reverses, it comes out of the ledger. If nothing is recovered, this statement never exists, because there is no fee.
Ask us the hard questions. Here are the answers.
These are the three questions every serious buyer should ask any company putting AI near their revenue. Most cannot answer them. We built the answers in.
Where does it fail?
Some claims are not recoverable. Expired appeal rights, patient responsibility balances, contractual write-offs. We tell you which claims those are and why, up front, instead of working them forever and calling it effort.
Who supervises it?
A person. The prediction engine proposes, drafts, and organizes. It does not send. Every appeal, every reconsideration request, every payer-facing document is reviewed and approved by a human before it goes anywhere.
Who owns the exceptions?
Anything ambiguous goes to a named review queue, not to a guess. A payment posts only when it matches exactly one claim. A claim gets accepted for work only when the evidence supports it. When the answer is unclear, the system says so and a person decides.
Recovery that teaches. Prediction that compounds.
Most vendors do one thing. Collection firms chase claims but never learn why they denied. Analytics tools report denials but never collect a dollar. Prexisio is one system: it predicts which claims will deny, prevents the preventable ones, recovers the ones that slip through, and learns from every outcome.
Every claim we recover for you becomes training data about how your payers actually behave. Which means the predictions get sharper, the prevention gets earlier, and the pile stops refilling.
That is the difference between hiring a service and building an asset.
Predict
Every claim is evaluated against intelligence built from your own adjudicated history. Not industry averages. Yours.
Prevent
Preventable denials get caught before submission, with the specific issue and the specific fix.
Recover
Denied, underpaid, and aged claims get worked on contingency, with a statement proving every dollar.
Learn
Every outcome, recovered or not, becomes training data about how your payers actually behave.
If you have the pile, you are who this is for.
Solo clinics, specialty groups, multi-site practices. Pain management, GI, spine, orthopedics, primary care, and everything between. The prediction engine trains on your claims, so it speaks your payer mix and your procedure codes, whether that is CPT 64483 or an office visit. What matters is not your specialty. It is that money you earned is sitting uncollected and the labor math never justified going after it.
See what qualifies for recoveryAsked by every practice. Answered plainly.
What does Prexisio cost?
Recovery is priced as a percentage of recovered dollars, agreed per placement before work begins. There is no setup fee, no monthly fee, and no minimum. If we recover nothing, you owe nothing.
What claims qualify for recovery?
Denied claims that were never appealed, claims paid below your contracted rate, aged claims with an open balance and no resolution, and small balances that were individually never worth the labor to chase. If you have a backlog, most of it is worth evaluating.
Do we need to install software or integrate anything?
No. You send the AR or denial export your practice management system already produces. There is no integration, nothing to install, and no new logins for your team. Your billing team receives a work order, not a dashboard.
How is our claim data handled?
Claim data is protected health information and we treat it that way. We store claim-level operational records only, we do not request clinical notes for recovery work, and no data moves before a business associate agreement is executed. Encryption in transit and at rest, access limited to the people working your claims, with audit logging. The Security page explains all of it in plain language.
Does the AI send things to payers automatically?
No. The prediction engine proposes, drafts, and organizes. A person reviews and approves every appeal, reconsideration request, and payer-facing document before it goes anywhere. Anything ambiguous routes to a human review queue rather than a guess.
What happens if nothing is recovered?
You pay nothing. You still receive the claim-by-claim evaluation showing which claims were recoverable and which were not, with the reason for each. If the pile turns out to be empty, that answer is free.
How do we start?
Send one file through the contact page. The first conversation takes about fifteen minutes: what you have, whether it is recoverable, and what happens next if you want to find out. Within days of placing a file, you see which claims will be worked, which will not, and why.
One file. No risk. You only pay on recovered dollars.
Send us one export and we will tell you, claim by claim, what is recoverable and why. If the answer is nothing, you will know that too, and it will have cost you nothing to find out.