Evident RCM recovers revenue from denied claims, underpaid cases, and OON negotiations that your current biller isn’t pursuing. No upfront cost. Results in 90 days.
Get a Free Revenue Call →| Procedure | Billed | Paid | Gap |
|---|---|---|---|
00630 Lumbar spine anesthesia — 18 base units billed, 12 paid |
$3,240 | $2,160 | −$1,080 |
99100Denied Qualifying circumstance — extreme age, not recognized |
$540 | $0 | −$540 |
QZ modifier removed CRNA supervision billing — downcoded without notice |
$1,800 | $1,080 | −$720 |
What independent surgical practices tell us
“I just want to get paid for work I’ve already done.”
“The surgical denials are ridiculous. The peer-to-peer calls are a sham.”
“Using the No Surprises Act to deny claims — even when the patient signed my disclosure.”
“The one problem I wish would disappear: claim denials by insurance companies.”
Insurance companies run the same playbook on every practice: low offers, bad-faith denials, dropped follow-up queries, peer-to-peer calls with reviewers from the wrong specialty. Independent practices rarely have the time or infrastructure to push back. That’s a calculated bet — and it pays off for payers every day.
Payers auto-downcode with no notice. Your biller posts the payment and moves on. The gap becomes permanent.
SCS implants, RFA, spine fusions — your highest-revenue procedures are the most complex to appeal, so they get abandoned. 82% of appealed denials are overturned.
The first offer is a negotiating position — not a settlement. Federal IDR and counterfiling exist for exactly this. Most billers never use them.
Wrong-specialty peer-to-peers. Denials queued before records arrive. NSA used against patients who signed your disclosure. Calculated bets that you’re too busy to fight back.
Representative outcomes. Every practice is different — the free Revenue Call shows you what’s realistic for yours.
Four capabilities, each targeting a different way payers underpay you.
Every denial appealed through all three levels. Aged A/R reworked. Nothing written off until every avenue — including federal IDR — is exhausted.
Initial offer declined. Counterfiled. Escalated to federal IDR when payers won’t move. The first offer is a negotiating position. We don’t treat it as anything else.
Every EOB compared against your contracted rates, line by line. Underpayments flagged and challenged before the window closes. Payer patterns tracked across your full claim history.
Full prior auth workflow managed. Every insurer query tracked and responded to within the window. Peer-to-peer calls prepared and run. Nothing dropped.
It’s not. We handle the full transition. Here’s exactly how it works.
20 minutes. We identify your highest recovery opportunities from your specialty, volume, and payer mix.
We run the full handoff in under 30 days while your current biller works normally. Zero clinical disruption.
Denied claims reworked. Underpayments challenged. OON cases negotiated. Dollars start coming back.
Monthly revenue reports. Direct access to our team. Every claim, denial, and OON negotiation tracked.
“I’ve been on peer-to-peer calls with reviewers from the wrong specialty. I’ve watched denials arrive before my records were received. I’ve seen billers accept the first OON offer because they didn’t think pushing back was their job. The tools to fight back exist. They just weren’t being used for us.”
Anupam Pradhan, MD — Founder & CEO · Board-Certified Orthopedic Surgeon · Chair of Orthopedics, Medical City Dallas
A 20-minute call shows you exactly what your practice is leaving behind — no obligation, no upfront cost.
Filing windows close. Denied claims age out. OON leverage disappears. A 20-minute call shows you what’s recoverable.