01 · Find
Map every dollar your payers held back
Denials and short payments by payer, reason code and amount, ranked by which filing deadline runs out first.
Payer concentration
SAMPLE FORMAT
Two kinds of lost revenue
You see the denials. Nobody sees the short payments.
Full denials
The claim pays zero and lands in a queue. Each one has a 90 to 180 day appeal clock, and when the queue is longer than the day, the smaller ones age out.
Short payments
The claim posts as paid and closes. Nothing flags it. E/M downcoding, line-item denials inside paid claims, NCCI bundling edits, unit reductions. All of it is in your 835 file, and almost nobody reads for it.
Claim ···1044 · Payer ADenied · paid $0
Shows up in your denial worklist.
Claim ···2207 · Payer BPosted as paid
- Billed
- 99214
- Paid as
- 99213
- Short
- $Y
Closed as paid. No worklist, no alert. This is the one we find.
SAMPLE FORMAT · NOT CLIENT DATA
What we do
From the remittance file to money back in your account.
02 · Recover
We do the recovery work, not just the report
Corrected claims, appeals and payer-level challenges for downcoding that keeps repeating. Your physician approves anything clinical.
03 · Prevent
See why it happened so fewer come back
Each recovery comes with the front-end cause behind it, by payer and reason code, so your team can fix it at the source.
Top recurring cause
Modifier 25 missing on same-day procedures
Payer BCO-4[N] claims
SAMPLE FORMAT
Industry benchmarks
The numbers your payers already know.
Published industry figures, not HawkClaim client results. Your audit gives you your own.
11.81%
of claims denied on first submission in 2024
Kodiak Solutions, 2,100+ hospitals
2.7%
of net patient revenue lost to final denials in 2025
Kodiak Solutions, median
#1
Audits and appeals, the top burden for medical groups. MA automatic downcoding ranks fourth.
MGMA Regulatory Burden Report, 2026
Getting started
One file in. Recovered revenue out.
No integration project, no new login for your team. We start with a file your clearinghouse or practice management system already produces.
- 01
Send one export
Twelve months of 835 remittance files, sent under a signed BAA.
- 02
Get your denial map
Every denial and short payment, with open deadlines first. Delivered as a report in about [X] days.
- 03
We work the recovery
Corrected claims, appeals and batch challenges. Nothing clinical goes out without your physician's approval.
- 04
You get paid
Recovered dollars land in your account, with the causes behind them.
Who we work with
Built for outpatient teams without hours to spare.
Ambulatory surgery centers
High-dollar cases where one missed deadline costs real money.
Specialty groups
Orthopedics, cardiology, dermatology, GI and pain, where downcoding hits partner income directly.
Multi-specialty groups
Many payers, many reason codes, one billing team stretched across all of them.
Billing companies
Run it across your client book under your own name. Talk to us
Administrators
No new budget line, no new software, no new hire.
Billing managers
We take the part of the queue nobody has hours for. You keep your payers and your process.
Physicians
About a minute to approve an appeal. Nothing goes out without your sign-off.
Your data
We ask for one file. Nothing else.
Most revenue tools start with an integration project and a security review. We start with an 835 export. If you're not sure who receives your remittance files, that's the first thing we'll help you find.
- BAA signed before any file is sent
- Encrypted in transit and at rest
- No EHR connection
- No logins or credentials
- Every access logged
- Clinician sign-off on anything clinical
Questions
- Where do I get an 835 file?
- Your clearinghouse or practice management system can export it. We'll walk your team through it.
- Do we need to change anything?
- No. You keep your systems, your billing process and your payer relationships.
- Does this replace our biller?
- No. We take the backlog, not the job.
- We outsource billing. Can you still help?
- Yes. We work with you directly or with your billing company.
- Does AI decide our appeals?
- No. Software finds and drafts. A licensed clinician on your side approves anything clinical.
- What do we get from the audit?
- Top denial reasons in plain English, your costliest payers, short payments on “paid” claims, open deadlines and your write-off rate against the 2.7% benchmark.
Find out what your payers owe you.
Send one file. We'll show you every denial and short payment in it, and which deadlines are closest.