Second-pass recovery, behind your biller
Denied claim · CO-97
Appeal drafted, filed, and tracked to payment
Avicenna Care works the denials and underpayments your biller can’t get to — appealing every viable claim, on contingency, without touching how you already run billing.
Built to work alongside the systems you already use
Revenue recovery should never come down to how many hours your team can spare.
Avicenna Care pairs AI agents with the appeal playbooks that actually win denials — from first touch through the hardest ones. Here’s what that looks like on real denials.
The same-day office visit is bundled into the procedure and zeroed out — even when it was a separate problem.
We attach the encounter note proving a separate, significant E/M service and appeal the bundling with modifier 25.
A 15-code fusion is paid on some lines and denied on others as 'not separately reimbursable.'
We appeal each denied line with the operative report and the payer's own policy — code by code.
Authorization was obtained, but the payer says it can't find it and denies the claim.
We pull the authorization from the payer's own portal and request reprocessing — the move a great biller makes, on every claim.
Aged claims quietly approach the filing deadline — after which they're written off forever.
We work the soonest-to-expire claims first, so nothing ages out while no one's looking.
AI agent + human reviewPaidPursue high-value claims that traditional outsourced vendors leave untouched — without adding headcount or switching billers.
You pay only on what we recoverContinuous follow-up keeps claims moving through the collections process instead of aging out.
Track exactly how each claim is worked, who touched it, and where revenue is recovered.
“If I can see exactly where it’s pulling from — an audit trail — I don’t see a reason I wouldn’t trust it.”— a physician in our discovery interviews (name withheld)
We work from read-only exports and the payer-portal access you grant — without changing your chart. Nothing is edited behind your back.
See exactly where each code, number, and document came from — a full evidence trail on every claim.
The agent drafts the appeal and gathers the proof. A person on your side approves before anything leaves under your NPI.
We work behind your billing company or business office, not instead of it. If you ever want more than recovery, that's your call — never a requirement.
Percentage-of-collections billing has to prioritize the big, fresh claims — that's just the economics. We're paid only when we recover, so the small and aging claims are exactly the ones we fight. (Contingency applies to commercial, Medicare, and workers'-comp claims.)
PHI stays in your systems. We sign a BAA with your center before we touch a single claim — and charts never leave your platform.
Every code and number links back to where it came from. That’s the audit trail.
Backed by Y Combinator · Building with our first design partners — independent Bay Area surgical practices
Send us your remit files and top payer contracts — BAA first; an 835 export from your PM system is all we need. You get a written audit back: the recoverable dollars we found, and exactly where each one comes from. If the number is small, you’ve had a free second opinion on your billing. Facility claims are where we start — surgeon-office professional-fee books get the same treatment.
Contingency pricing applies to commercial, Medicare, and workers’-compensation claims. Medicaid engagements are priced flat, as federal rules require. Prefer to estimate it yourself first?
