You pay when we win the denial back. Not before, and not otherwise.
One unit, matched to how you get paid: a flat fee if you dispense, a share of the recovery if you bought the drug up front. No licence, no seats, no subscription and no monthly commitment — an appeal we file and lose costs you nothing at all.
What it costs
Two prices, because there are two ways you get paid
We agree which one you are on the first call, not after the pilot. Settling the unit later would mean re-trading price at the exact moment we are asking you to commit.
Specialty pharmacy
Dispensing under the pharmacy benefit
Nothing otherwise.
There is no single claim value to take a percentage of, and a percentage of a drug's price would eat the margin on the fill. So it is one flat number, and only when the appeal succeeds.
Clinic or practice
Buy-and-bill or in-office infusion
Nothing otherwise.
You bought the vial before reimbursement was certain, so a denial has an unambiguous dollar amount attached. We take a share of what comes back, and nothing if nothing does.
Preparing the authorizations that come after is part of the service once we are working your denials. It is never billed as its own line.
How it starts
Free to judge us. Full rate to use us.
The audit is free because you should be able to see the work before anything changes hands. The pilot is not discounted, because a discount answers a question you were not asking.
Step 1 · Free
Five closed denials
Send five denied specialty cases you have already lost, de-identified. We tell you which we judge were winnable, the exact criterion each turned on, and draft the appeal for the strongest. You keep all of it either way.
Step 2 · Full rate
A 30-day pilot
Live cases at the normal rate for your segment, with no contract. You can stop at any point, and a denial we do not win costs you nothing. What the pilot concedes is terms, not price.
Step 3 · Same rate
Founding partner
The rate locked for twelve months, and priority turnaround. Because the pilot already ran at full rate, nothing changes on price at the moment you commit.
Why this number
Priced against what a win costs you now
Not against what software costs, and not against an hourly rate. The comparison that matters is your own team's cost to win the same appeal — including the attempts that fail.
74 min
of a clinical pharmacist's time to work a single appealed authorization — roughly 3–4× a routine one
AJMC
$67.74
median pharmacist hourly wage on a 40-hour basis, so one appeal attempt costs about $84 of bare wage — win or lose
BLS, May 2025 · $84 derived
$170–230
what one successful appeal costs a team internally, if half their attempts succeed
Derived, not measured
$1,300–3,000
the monthly cost of the rheumatoid arthritis biologic a single denial holds up
JMCP
That arithmetic is the pharmacy case, where the question is what an appeal costs your own team. If you bought the drug up front, the comparison is a different one: the choice on a denied claim is a share of what comes back against the whole of it staying lost, on a vial you have already paid for and already given.
Two figures above are derived rather than measured: the ~$84 of wage per attempt, which follows from the first two, and the $170–230 per successful appeal, which additionally assumes half of attempts succeed. We would rather show you the arithmetic than a rounder number with nothing behind it.
Start with five denials you've already closed
Send five denied specialty cases, de-identified. We'll tell you which we judge were winnable and draft the appeal for the strongest. Free.