Revenue integrity for independent
specialty practices.
We find the denied and underpaid revenue slipping past your practice — and recover it, payer by payer. Paid only on what we collect.
How it works: diagnose, strategize, recover.
We diagnose.
We find the revenue you're losing — denied claims, underpayments, and the patterns your reports don't surface. Which payers, which codes, which denials repeat, and how much is realistically recoverable. Most practices are surprised by the number.
We strategize.
Every claim we take on gets worked the way that claim is most likely to win — not run through a generic appeals template. We match each denial and underpayment to the approach the data says lands: the appeal path that works for that payer, the underpayment they're counting on you to miss, the denial reason they reverse under pressure. We've learned how insurers stall, downcode, and deny by default — and we build each recovery around beating those patterns, payer by payer.
We recover.
We work the claims to resolution — appeals, corrected submissions, underpayment challenges — and you see the money. Paid only on what we collect. Nothing added to your billing team's desk.
What we go after.
Most denied claims are not write-offs. They're fixable — a missing modifier, a CARC the payer applied incorrectly, an authorization on file that never made it onto the 837. Payers count on nobody appealing. Every day a denial sits, it drifts closer to the timely-filing wall the payer is measuring against — which is exactly the outcome the payer's playbook is built around.
- Missing or invalid information
- Coverage and eligibility issues
- Medical necessity disputes
- Authorization and referral gaps
- Coding and modifier corrections
- Coordination of benefits
- Underpayments against contract
What an engagement looks like:
a seven-physician orthopedic group.
Modeled on typical denial patterns for a practice this size — about $312K in recoverable denials worked over a quarter, without adding a single task to the practice's billing staff. Your number comes from your own data. That's the free estimate below.
Average recovery rate on worked denials
Median annual leakage at a five-provider practice
To first recovered dollar from connection
Paid only on what we collect.
No setup fee. No monthly minimum. No per-claim charge. We take a percentage of what we recover, invoiced monthly against payments that have actually landed in your account. If a quarter passes with nothing recovered, you owe nothing for that quarter.
Percentage tiered by recovery volume. Disclosed in writing before any work begins.
Clearia fits if a few things are true.
Yes if —
- You're an independent practice with 1 to 15 providers.
- You receive electronic remittances from your payers through a clearinghouse.
- Your billing team is focused on keeping current-month claims clean, and denials older than 60 days rarely get worked before the timely-filing wall closes.
- You suspect you're leaking revenue but don't have a number for it.
- You bill commercial, Medicare, or Medicaid — or all three.
No if —
- You're a hospital system or ASC. Different problem, different tooling.
- You have an in-house denial management team you're already happy with.
- Your AR is in catastrophic shape and needs a turnaround consultancy, not a recovery partner.
- You don't want anyone outside the practice touching claims.
For practice administrators.
You're the one who'll actually work with us, so here's the honest version: we sign a BAA before any data moves, we connect read-only, and we never touch the claims your team is already working — you set the line, we take what's below it. Weekly recap, no new software, no new logins for your staff. If a recovery needs something from your side, it's a question, not a task.
See what's recoverable.
Send us 90 days of your remittance data. We'll send back a written estimate of what we believe we can recover, at no cost. No connection required to receive the estimate.
Request an estimateOr email estimates@cleariagroup.com directly.