Revenue recovery for medical billing companies

We don't just find your missing revenue.
We recover it — and prove it.

Claivex tracks every denied and underpaid claim through to a recovered dollar, and ties that dollar to the payer's own remittance line. So "we recovered $X for your clients" is a number you can put in front of a CFO — not a projection.

Prefer email? Send your de-identified CSV to oadenupe@claivex.net.
Runs on de-identified data — your patients' PHI never leaves. HIPAA Limited Data Set.
~50%
of denied claims are never worked — for lack of time, not merit (MGMA / Experian)
80.7%
of Medicare Advantage denials challenged at review are overturned (KFF / CMS)
192.7M
records exposed in the Change Healthcare breach — the case for data that never leaves
The problem
The money isn't lost. It's unworked, unproven, and hiding.

Your team gets hundreds of denials back a month. The $8,000 Anthem denial gets a letter. The $180 Cigna denial joins the pile. Meanwhile, claims that show as "paid" came in below your contracted rate, and whole employer accounts quietly pay you nothing while your aging report calls it normal.

The tools you can afford show you a list. They don't recover anything, they can't prove a recovered dollar, and they never catch the account that's structurally broken. The tools that do more cost $50,000+/year and are built for hospitals with IT departments. That gap — real recovery, provable, built for billing companies — is Claivex.

Why Claivex

Four things nobody else does at this level.

01

We prove it, we don't just list it

Every recovered dollar links to the payer's 835 remittance line and is attributed to the work that earned it. Your recovery number survives an audit. No competitor at this price point can produce the receipt.

02

Your patients' PHI never leaves

Claivex runs on a de-identified Limited Data Set — dates and geography, never names, DOB, SSN, or member IDs. After the Change Healthcare breach, that's the architecture, not a footnote.

03

Prevention, not just recovery

Claivex scores outbound claims for denial risk before they're submitted, with the specific fix to make. Stopping a denial beats appealing one — and it's a daily habit, not a one-time audit.

04

We under-claim on purpose

Payer variance and coding signals are labeled intelligence, never revenue. Expired claims count as $0. In a category full of AI tools that overpromised, the number we show you is the one you can trust.

What it does

Six ways Claivex turns your claims data into money.

CapabilityWhat it meansThe money
Proven recovery

Ranked appealable denials + underpayments — each recovered dollar tied to the remittance line that proves it.

Recovered, attributed
A/R Collections Intelligence

Authoritative A/R status + detection of whole accounts that have paid you $0 — broken billing hiding as normal aging.

Receivable you're not collecting
Pre-bill prevention

Scores outbound claims for denial risk before submission, with the fix to make.

Denials that never happen
Prompt-pay interest

Statutory interest payers legally owe on late payments, calculated per state.

Money you're already owed
Refund / credit compliance

Overpayments flagged on the CMS 60-day clock.

False-Claims exposure avoided
Multi-client dashboard

Every client's denial rate, Revenue Health Score, and recovery in one view.

A portfolio you can manage
How it works

Days, not months. No integration, no IT project.

1

Export your data

Pull claims from your PM system with our 10-minute guide (eCW, Kareo, athenahealth, AdvancedMD, Tebra). De-identified — no names, DOB, SSN.

2

We run the audit

If we don't find it, you pay nothing. No implementation, no integration.

3

You get real numbers

Ranked denials, underpayments, stuck A/R and never-paid accounts, payer grades — every finding traced to a source claim.

4

Monitoring recovers it

And catches the next never-paid account at ~$10K instead of $50K — proof attached to every recovered dollar.

What one real audit surfaced
$53,900

in collectible A/R the denial analysis never would have touched.

On the first real eClinicalWorks practice we ran, the A/R layer surfaced three employer accounts that had paid $0 — never-paid, not slow-paid — all traced to a single upstream billing break around one date. Diagnose one claim, likely unlock the rest.

Figures are dollars detected — collectible receivable identified, not yet collected. We show detected vs. collected separately, always. That honesty is the product.
Pricing

Priced on proven value, not seats.

We start with an audit that shows exactly what's recoverable in your data — before any subscription. If we don't find it, you pay nothing. If we do, a simple monthly fee keeps recovering it.

Book a 20-minute call →
No 2-year contract No per-provider surprises Your data is always yours
Questions

The things billing companies actually ask.

How do I know your recovery number is real? +
Every recovered dollar links to the payer's own remittance line. Open the ledger and check any one of them. That's the whole point of Claivex.
We already use Waystar / Tebra. +
Keep them. Claivex is the layer they don't have — what happens after the claim goes out (recovery, proof) and before it goes in (prevention). We're not a clearinghouse and not a PM system.
Is my patient data safe? +
It never leaves as PHI. Claivex only works on a de-identified Limited Data Set (dates and geography, never identifiers).
Percentage pricing feels risky. +
Our model is value-based and audit-first, and any performance component is capped and billed only on proven recovery — you never pay on a dollar we can't show you the receipt for. Flat pricing is available if you prefer predictability.
How long to get started? +
Days, not months. Export a CSV, we run the audit, you see real numbers. No integration required.

See what's actually recoverable in your data.

Send one clinic's de-identified CSV. We'll show you the real number — traced to the source claim — within 48 hours. If we don't find recoverable revenue, you pay nothing.

Start with a de-risked audit →