Intelligent Healthcare

What you get back in 48 hours

This is the report. Yours, on your own numbers, free.

Below is a real Denial Opportunity Analysis — the exact deliverable we return within two business days of receiving your 835 files. This one runs on synthetic data so we can show it publicly; yours runs on your practice's actual remittances.

Denial Opportunity AnalysisSample · synthetic data
Illustrative — not a real practice
$7,100 estimated recoverable across 4 denied claims totaling $11,950 denied — every dollar of it appealable. Recovery estimate is calibrated per payer and denial category from recorded appeal outcomes.

Denied dollars by payer

PayerClaimsDeniedAppealableEst. recovery
National HMO Plan2$6,050$6,050$3,600
Regional Blue PPO2$5,900$5,900$3,500
Total4$11,950$11,950$7,100

Denied dollars by category

CategoryClaimsDeniedAppealableEst. recovery
Medical necessity2$7,700$7,700$4,700
Prior authorization2$4,250$4,250$2,400

Highest-value appeal targets

1
National HMO · CARC 50 · medical necessity · acct ACT-102
Clinical appeal mapping documentation to the payer's own medical-policy criteria — the strongest overturn class.
$4,200at stake
2
Regional Blue PPO · CARC 50 · medical necessity · acct RB-118
Clinical appeal citing the documented failed conservative-treatment trial before the ordered service.
$3,500at stake
3
Regional Blue PPO · CARC 197 · authorization · acct RB-091
Retro-authorization request, or appeal citing urgent/emergent circumstances or payer notification failure.
$2,400at stake
4
National HMO · CARC 197 · authorization · acct ACT-101
Retro-authorization request, or appeal citing urgent/emergent circumstances or payer notification failure.
$1,850at stake
Prepared by Intelligent Healthcare · synthetic sample · every figure above is read directly from the 835 remittance files — the only thing we need to produce this for your practice.
How to read it

The recoverable number

Not "denied dollars" — the portion our engine estimates you can actually win back, calibrated from real appeal outcomes by payer and denial reason.

How to read it

Ranked, not listed

Targets are ordered by expected value — the odds of overturning times the dollars at stake — so the first hour of work goes to the most recoverable money.

How to read it

Every next move named

Each target comes with the specific argument we'd make. Nothing is a black box; your team sees exactly what would be filed and why.

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