Pricing
One implementation fee. One monthly fee. No hourly meters.
Priced against what a denial costs and what a clinical appeals nurse costs, not against hours. Every plan starts with a working proof on your own denials before the implementation fee is committed.
Pricing
One implementation fee. One monthly fee. No hourly meters.
One clinical appeals nurse costs about $94,500 a year. One unappealed inpatient denial can exceed $14,000. This is priced against those numbers, not against hours.
Platform
Multi-facility, inside your compliance boundary.
from $400,000 over 12 months
Includes up to 150,000 denials a month across all facilities
Written quote in the 48-hour roadmap. No assessment fee.
- Every workflow across facilities and entities
- Dedicated environment in your cloud, BAA signed
- Fractional Head of AI seat
- Quarterly executive briefing and diligence pack
- Security review support for your IT and compliance teams
- Everything in Revenue Cycle
Revenue Cycle
RecommendedAppeals plus two more workflows across the revenue cycle.
$204,000 over 12 months
Includes up to 50,000 denials a month (calls or reviews on the adjacent workflows)
- The appeals engine
- Two of: patient-access call coverage, plain-English reporting over denial data, patient review response
- A plain-English analyst over your own denial data
- Biweekly roadmap sessions
- Priority engineering response
- Everything in Appeals Engine
Appeals Engine
Every appealable denial, appealed.
$95,000 over 12 months
Includes up to 10,000 denials a month
The smallest tier. A group under 3,000 denials a month gets the same engine at the same price, well inside the limit.
- The appeals workflow, Epic or Cerner over FHIR
- Reviewer sign-off on every letter, edits tracked
- Weekly releases into your environment
- Monthly results review with the engineer
- Coverage, accuracy, and cost per appeal reported
- 90-day performance guarantee with term exit
Included in every plan
- You own all source code, documentation, and runbooks from week one
- Working proof on your own denials before the implementation fee is committed
- Your nurse or denials specialist approves every letter, with an audit trail
- PHI stays in your cloud tenant; the model call goes through a private, HIPAA-eligible endpoint under BAA
- Cost per appeal, coverage, and accuracy reported to you monthly
- Model routing and fallback across providers, PII redaction, and guardrails
Every plan carries the 90-day guarantee with term exit: two agreed numbers, fee pause if missed, and the right to end the term after 30 days' notice.
Usage above the plan limit is passed through at model cost with the invoice attached. Your monthly review shows cost per appeal, so there are no surprises.
12 months standard, starting at launch. A 36-month partner term with a locked price is offered after the 90-day guarantee period, once you have a number. Contracts are assignable to an acquirer at no charge.
All prices in USD.
What you get
What you get, and what each piece is for
- 01
The appeals engine, live in 4 to 8 weeks
Record retrieval, clinical evidence, payer policy, and letter generation, with reviewer sign-off, deployed in your EHR environment. In production this took under 2 minutes per appeal against 30 to 60 by hand, and the hospital group recovered millions in denied inpatient claims.
What it kills: Denials expire unappealed because nobody has the hours.
- 02
Working proof on 50 of your own denials before the fee
We run fifty of your real denials, under NDA and BAA, and your reviewer scores the letters. You get a written go or no-go, and "do not build" is a real answer we give.
What it kills: Pilot purgatory and vendor slideware.
- 03
A 48-hour roadmap with your denial math
Architecture, integration path, timeline, price, and your own numbers: denial rate, overturn rate, unappealed volume, and expiring deadlines.
What it kills: "Is this worth it?" and "will IT allow it?"
- 04
Week-one data audit and a one-page readiness checklist
Written findings on record access, denial exports, and gaps, plus the list of what we need, from whom, for about one hour a week.
What it kills: "Our data is a mess" and hidden effort on your side.
- 05
Your reviewer signs every letter
The system drafts; your nurse or denials specialist approves. Edits feed back into accuracy. Staff move from an hour of typing to minutes of review.
What it kills: Clinical and compliance fear, and staff resistance.
- 06
Monthly results review
Coverage, accuracy against reviewer edits, cost per appeal, cycle time, and dollars in flight, on one page you can put in front of the board or the owners.
What it kills: "We cannot measure the impact."
- 07
Quarterly executive briefing and a diligence pack
What shipped, what it earned, what is next, plus the architecture, audit trail, evaluation results, and ownership documents a buyer or lender will ask for.
What it kills: "What is our AI strategy?" and quality-of-earnings scrutiny.
- 08
You own all of it
Code, documentation, runbooks, and training, from day one. If SASID disappears, the system does not.
What it kills: Bus factor and lock-in.
The 90-day guarantee
Before we build, we agree in writing on two numbers: the share of denials the engine drafts a letter for (coverage) and the share of drafted letters your reviewer accepts with under five minutes of edits (accuracy). If either number is below target at launch or at any point in the first 90 days, for any reason on our side, we fix it at no charge and the monthly fee pauses until it is met. If it is not met within 30 days of your written notice, you may end the term, owe nothing further, and keep all code, documentation, and runbooks. The implementation fee is earned at launch and is not refunded.
Your side: read access to the systems in the readiness checklist within 10 business days, one named champion for about an hour a week, and reviewer feedback on drafted letters within 5 business days. Full wording is in the agreement.
Onboardings are scheduled monthly and limited to two or three at a time so every launch gets the engineer's full attention. A signed agreement holds a date.
Run it on 50 of your denialsThe cost of doing nothing
Put your own numbers in.
A few sliders, no email required. The estimate uses your inputs and the stated assumptions, nothing hidden, so you can check the math before you talk to anyone. Bring the numbers to the call and the roadmap does this math for your group, in writing.
Denial appeals
CFO or VP of revenue cycle at a hospital system or physician group
Median was 2.7% in 2025 (Kodiak Solutions, 2,300+ hospitals). Edit it if you know yours.
Your call. About one physician in five says their practice always appeals an adverse prior auth decision (AMA, 2025).
Used with net revenue to pick the tier that fits you.
- Overturn rate on appeals you file today:
- 70% Premier Inc., 2025
- Applied to denials you have never fought:
- 35%, half the rate, because the easy ones are already being appealed
Final denials written off every year
- $4,050,000Final denials written off per year
- $2,430,000Of which never appealed
- $425,250Recoverable at the stated assumptions (cannot exceed the write-off)
- $95,000Year-one cost of the tier that fits your volume (Appeals Engine)
The estimate starts from what you already wrote off, not from initial denials, and it applies half the industry overturn rate to denials nobody chose to fight. Bring your own final denial number to the call and the roadmap redoes this math for your group, in writing.
Questions revenue cycle leaders ask
An AI appeals system built and run inside your EHR environment by the senior engineer who built the original, plus the monthly operation of it. The implementation fee covers integration with Epic or Cerner over FHIR, the payer policy corpus, evaluation against your reviewers, and launch. The monthly fee covers hosting in your tenant, model costs within plan limits, monitoring, tuning, the monthly results review, and the engineering time in your plan.
Get started
Send us 50 of your denials. Get the math back in writing.
Thirty minutes on a call, then a written roadmap within 48 hours: the workflow, the systems it connects to, the price, and what doing nothing costs at your volume. Then fifty of your real denials, under NDA and BAA, drafted and scored by your reviewer before any fee.
- Free 30-minute call
- Written roadmap in 48 hours
- Proof on 50 of your denials before any fee
Book the 30-minute call
Thirty minutes. You bring the leak and the volume; within 48 hours you receive a written roadmap covering the workflow, the integrations, the price, and the cost of doing nothing at your numbers.
- 0130-minute call
You bring the leak and the volume. We map it to one workflow and the system it lives in.
- 02Written roadmap in 48 hours
The workflow, integrations, timeline, price, and the cost of doing nothing at your numbers. If the numbers do not support building, the roadmap says so.
- 03Proof on 50 of your denials
Fifty real denials (or two hundred calls, or a week of reviews for adjacent workflows). You see the letters and the accuracy before any fee is committed.
- 04Live in 4 to 8 weeks
Weekly releases into your environment, then the 90-day guarantee clock starts.
Prefer to write it down?
Starts are scheduled monthly. A signed roadmap holds a date.