Claro Health  ·  Denial Recovery for Independent Practices Phase 0 · May 2026

Recover the revenue
your practice writes off.

We read 12 months of your denied claims, identify what's still in the appeal window, and hand you back drafted payer-specific appeal letters — in five business days. Your team reviews and submits. Nothing auto-files.

Money-back if we don't find $2,000+ 5 business day turnaround No long-term contract
What the audit identifies

Denied claims still inside the payer's appeal window, triaged by CARC code, dollar amount, and payer policy — with a drafted appeal letter for each one.

You get back:
  • 7-page audit report with triage funnel + denial pattern analysis
  • Recovery projection by CARC code (conservative / expected / optimistic)
  • Draft appeal letters for top 20 opportunities — policy citations included
  • Submission checklist + timely filing deadlines per claim
Audit fee
$499
Guarantee floor
$2,000
Turnaround
5 days
Draft letters
Top 20
Payer policy coverage
UNITEDHEATH
ANTHEM BCBS
AETNA
CIGNA
HUMANA
MEDICARE
MEDICAID
02 / THE GAP Why the money stays with the payer

81.7% of appealed denials
are overturned.
Only 11.7% of denials
ever get appealed.

The gap between those two numbers is your monthly write-off. Small practices abandon recoverable revenue not because the appeals don't win — they do, at staggering rates — but because nobody on the team has 45 minutes to draft each letter from scratch. That's the problem this audit solves.

Source · KFF / CMS Denial Rate Study, 2024
Industry benchmarks
Denials that are never appealed 88.3%
Denials that are appealed 11.7%
Overturn rate when actually appealed 81.7%
The math is simple: the appeals win at an 81.7% rate, but practices only attempt 11.7% of them. The audit identifies which denied claims are still inside the appeal window and drafts the letters — closing the gap between "didn't get to it" and "submitted and won."
03 / THE OFFER The $499 Denial Recovery Audit
$499
flat fee · one-time
If we don't surface at least $2,000 in recoverable revenue, the audit is free. No questions asked.
  • 12 months of your denied claims reviewed — you send them, deidentified, via our secure intake
  • Every claim triaged: appealable vs. not, timely filing status, CARC prioritization
  • 7-page audit report: denial pattern analysis, triage funnel, recovery projection by CARC code
  • Draft appeal letters for the top 20 recoverable opportunities — each with payer policy citation
  • Per-claim submission checklist: payer address, attachment list, timely filing deadline
  • 30/60/90-day outcome tracking: send us what happened, we calibrate projections for the next audit

The intake takes about 20 minutes on your side. You deidentify the claims (we send a one-page checklist), upload them through our secure portal, and we do the rest. Five business days later, the report and letters are in your inbox.

How intake works
1
Receive the redaction checklist
One page. Lists the 18 HIPAA Safe Harbor identifiers to remove. Takes most billing teams 20–30 minutes for a full 12-month batch.
2
Deidentify and upload
Strip names, member IDs, dates of birth, and the other identifiers. Upload via our secure portal. ZIP multiple files into one batch.
3
We triage, draft, and deliver
5 business days. Report + 20 draft appeal letters, each with a cover sheet, attachment checklist, and payer-specific policy citation.
4
Your team reviews and submits
Attach the clinical note, sign, submit via payer portal or certified mail. Human sign-off on every appeal — nothing auto-files.
All claims processed under HIPAA Safe Harbor de-identification (45 CFR 164.514(b)(2))
04 / WORKFLOW From denied claim to drafted appeal

Every claim goes through the same five-step triage. Nothing passes that shouldn't.

Step 01
Secure intake

You send deidentified EOBs or ERA files through our secure upload portal. PHI never touches plain email. All data transmitted and stored under HIPAA Safe Harbor.

Step 02
Triage

Every claim is screened: Is it provider-appealable? Within the timely filing window? Above the $75 economics threshold? CARC code in the appealable category? Clinically supportable?

Step 03
Draft

Each appeal is drafted with an opening, clinical rationale, payer policy citation (by document title and section — no fabricated references), CARC rebuttal, and attachment checklist. Reviewed by a human before delivery.

Step 04
Submit

Your billing coordinator reviews each draft — typically 3–5 minutes per letter — attaches the clinical note, and submits through the payer's portal or by certified mail. Accountability stays with you.

Infrastructure
Secure cloud · HIPAA-eligible configuration
AI drafting
Anthropic Claude · BAA in place
Data standard
HIPAA Safe Harbor · 45 CFR 164.514(b)(2)
Human review
Every draft reviewed before delivery
05 / RECOVERY ESTIMATE ROI calculator · move the sliders Based on KFF / CMS industry data
Your practice
Providers 3
Claims submitted / provider / month 300
Denial rate 12%
Avg claim value $200
Estimates use KFF / CMS industry benchmarks only — not Claro-specific data. "Current recovery" assumes the industry average of 11.7% of denied claims appealed × 81.7% overturn rate. "Potential recovery" shows what would happen if 60% of denials were appealed at the same industry overturn rate. Your actual results depend on payer mix and claim types.
Estimated annual opportunity gap
$127,400
Additional revenue recoverable annually if 60% of your denied claims were appealed, vs. the industry baseline of 11.7%.
Denials / month
108
$ at risk / month
$21,600
Currently recovering / mo
$2,063
at 11.7% appeal rate
Potential recovery / mo
$10,605
if 60% of denials appealed
The wedge offer

Send a year of denials.
We'll show you the money.

The $499 Denial Recovery Audit reads 12 months of your denied claims, identifies what's still in the appeal window, and hands you back drafted appeal letters for the top 20 opportunities. If we don't surface at least $2,000 in recoverable revenue, the audit is free.

No long-term contract Money-back guarantee 5 business day turnaround Human review on every draft