We classify every denied and aged claim by root cause and return a written report with the recoverable-revenue range. Most audits finish inside an hour of upload, watchable live. No cost. No retainer. No commitment.
A/R Audit Report
Sunshine Orthopedic Group
Period reviewed: last 180 days. 1,284 denied claims.
Recoverable
$74.3k
Work Ratio
67%
Top denial categories
Illustrative preview. Your audit will be personalized to your practice.
Tuned for specialty-specific denial patterns
~1 hr
Typical audit completion time
19 CARCs
Denial types classified line by line
30%
Contingency if you hire us after the audit
The opportunity
Industry data (HFMA, MGMA) is consistent: between sixty and eighty percent of recoverable denials are overturned when they are actually worked, and roughly half of all denials never get touched at all. The gap is not clinical. It is operational. Your team is busy billing today's charges and your aged A/R gets older.
The audit tells you exactly how big that gap is at your practice.
Medical-necessity denials (CARC 50)
Denied on LCD/NCD language the payer says was not met. Most are overturnable with a short appeal letter citing the correct clinical documentation.
Typical range
$18k to $42k
Missing-modifier denials (CARC 16, 97)
Modifier 25, 59, 76, 77, TC, or 26 missing on a same-day E/M or procedure pair. Quick resubmission recovery.
Typical range
$12k to $28k
Prior-authorization denials (CARC 197)
Payer says auth was not on file. Many are retro-auth eligible inside the filing window. Peer-to-peer often available.
Typical range
$22k to $65k
Timely-filing denials (CARC 29)
Most are truly written off, but around one in six has a valid good-cause exception (277CA proof, retroactive eligibility, payer outage) that overturns.
Typical range
$6k to $18k
Ranges reflect typical recoverable amounts per category for practices with one to five providers and between one thousand and five thousand denied or aged claims. Your numbers will vary.
How it works
You do two things. Everything else is on us.
Standard Business Associate Agreement, reviewed and signed inline. About three minutes. No DocuSign link to wait for.
CSV or Excel export from Athenahealth, AdvancedMD, eClinicalWorks, Kareo, DrChrono, or any other practice management system. Short on time? Ask us to pull it for you.
Our AI triage engine classifies every denial by CARC. A licensed AR specialist reviews and signs off. You can watch progress live while it runs.
Usually inside an hour. Recoverable-revenue range, root-cause breakdown, prioritized action list. Yours to keep either way.
Before and after
Without an audit
After your audit
“We had $74,000 sitting in aged A/R we had written off. Recovery Engine pulled back $51,200 in the first ninety days. The audit itself cost us nothing to find out what was recoverable.”
Maria Lopez
Practice Manager, Sunshine Orthopedic Group, Houston
Security and compliance
HIPAA compliant
BAA executed before any PHI transmission. AES-256 encryption at rest, TLS in transit. Full audit log of every access.
Your data stays yours
You own your claim data. Export or delete at any time. We do not sell, share, or reuse your information outside your audit.
Contingency only
If you engage us for recovery work after the audit, our fee is thirty percent of the cash we recover and post to your account. No retainer, no setup fee.
Common questions
Our AI triage engine classifies every claim and calculates the recoverable range. A licensed AR specialist then reviews and signs off on the final report. A human signs every report before release.
An export of claims that are denied, partially denied, or aged beyond sixty days. Typical exports include claim ID, date of service, CPT, ICD-10, billed and paid amounts, denied amount, payer name, and any CARC or RARC codes present. If you are not sure what to export, a fifteen-minute call clarifies it.
Up to one hundred megabytes per upload. For practices with larger volumes we support multi-batch uploads at no additional cost.
No. The audit is a written professional assessment, not a guarantee. If you choose to engage our recovery service afterward, we work on contingency, which means a fee only when money is actually recovered and posted to your account.
No. The audit is an independent assessment of denied revenue sitting in your aged A/R. Many practices use our findings to validate or challenge their existing biller. You are free to act on the report however you choose.
You can direct us to delete the uploaded claim file and report at any time. If you do not retain our recovery service within ninety days, the data is automatically archived and subsequently deleted in accordance with our BAA and data retention policy.
Your audit, when you want it
No sales call. No invitation required. Sign the HIPAA agreement, upload your claim file, and watch your audit run. Your written report lands in your inbox when it’s done.
Free AR audit. Live progress. Usually under an hour.
No retainer. No commitment.