Use cases
Where the agents pay for themselves.
Four workflows every billing operation runs by hand today. For each one, the playbook is the same: where the leak is, the workflow change that closes it, and what the math looks like at your scale.
Found Money
Found Money: the coverage finder for your self-pay book
Patients had Medicaid retroactive. They had secondary coverage. They had workers' comp. You already wrote it off as self-pay. Found Money is the agent that reads your self-pay book and tells you which patients had eligible coverage you can still bill.
$27,900/mo
Average recapture, per 25-clinic billing book
CARC playbook
Reduce CARC 197 (missing-authorization) denial volume by 50 to 65%
CARC 197 is the most common preventable denial in outpatient billing. A pre-submission scrubber + auth log discipline pulls the volume down, while a denial classifier wins back the ones that still slip through.
50 to 65%
Reduction in 197 volume within 90 days
Denial recovery
Triage aged AR by expected recovery, not by date
The aging report tells you what's old. It does not tell you what's worth fighting for. NxtPivot ranks aged AR by expected recovery so your team works the highest-yield claims first.
3 to 5x
Higher revenue per work-hour on aged AR
Pre-submission
Pre-submission claim scrubbing for behavioral health practices
Psychiatrists and therapists run 16 to 20% denial rates against a 5 to 10% industry average. A specialty-trained scrubber agent flips the math, catching mismatched DX, missing modifier 25, and parity-violation patterns before the claim leaves the clearinghouse.
40 to 60%
Reduction in preventable denials, behavioral health specifically
Want this on your own data?