Recover / Contingency recovery
Give unresolved payer revenue the attention it needs.
Get help reviewing and pursuing eligible denials, underpayments, and write-offs while your team manages current billing.
Discuss recoveryWhere we can help
Different reasons for a shortfall.
One need for resolution.
Denied claims
Claims that may warrant further action, subject to the payer decision, available documentation, and applicable deadlines.
Underpayments
Payments that may fall short of applicable reimbursement terms, including balances that already appear closed.
Eligible write-offs and older balances
Previously unresolved payer amounts that still have a supportable path to recovery. Age or a write-off alone does not establish that money is recoverable.
The engagement
From unresolved claims
to a clear financial record.
We handle the agreed recovery work, coordinate with your team, and keep outstanding information and decisions visible.
Review the engagementEstablish what can be pursued
Your historical claims and supporting information help establish the scope. We distinguish supported recovery opportunities from items that need more evidence or should not proceed.
Work the agreed claims
Coordinate payer correspondence, follow-up, and required approvals within the engagement. Your team knows where its input is needed.
Confirm what was recovered
Report additional payer money received by your practice and the associated agreed fee. A payer approval or remittance alone does not establish recovered cash.
Contingency, with accountability
No recovery,
no recovery fee.
The recovery fee is an agreed percentage of eligible, verified recovered revenue. Scope, rates, exclusions, and any other commercial terms are established in writing before work begins.
Reporting distinguishes confirmed recovery from unresolved balances. Returns and adjustments must also be accounted for.
A recovery you can account for.
Example of how a recovery is reported. These are fictional amounts, not client results.
- Additional payer payment received by the practice
- $1,000
- Recovery eligible under the agreement
- $1,000
- Example agreed contingency rate
- 20%
- Prexisio recovery fee
- $200
- Practice retains after the recovery fee
- $800
A payer approval alone is not recovered cash. Actual fees depend on your agreement and verified recovery. The example rate is not a price quote.
Questions about Recover
Know where
the boundaries are.
Is every denied or written-off claim recoverable?
No. Contract terms, payer decisions, deadlines, documentation, and prior payments affect whether further recovery is supportable. We do not promise a recovery amount before reviewing the evidence.
What information is needed?
Historical adjudicated claims are the starting point, typically covering 13 months. Payer contracts, remittances, and supporting records may also be needed. We agree on the information and secure transfer process during onboarding.
How long does recovery take?
Timing depends on the claims, available information, payer requirements, and responses. We discuss expectations for your scope and report progress rather than promise a universal recovery date.
Does Recover include patient balances?
No. Recover is limited to eligible insurance and payer reimbursement. We do not pursue patient responsibility.
A practical next step
What is still unresolved at your practice?
Tell us about the denials, payment shortfalls, or older balances you want to address.