Five steps.Nothing starts without your signature.

Every engagement runs on the same schedule. You see what we find before you agree to anything, and you see what we did every month after.

Schedule of engagement

  1. 1.Clause 1

    Free claims audit

    You give us read-only access to a sample of denied and unpaid claims, under a short data processing agreement. We spend [[AUDIT_EFFORT_HOURS]] hours on it. You spend about 30 minutes.

    Party
    You and us
    Timing
    Week 1
    • 1.1Read-only access, revocable at any time
    • 1.2No fee, no obligation
  2. 2.Clause 2

    Written findings

    A written report: what we found, claim by claim, why claims failed, and an estimated recoverable amount. With a recommendation — which may be to fix it in-house.

    Party
    Us
    Timing
    Within [[AUDIT_TURNAROUND_DAYS]] working days
    • 2.1Estimated recoverable amount
    • 2.2Root causes behind denials
    • 2.3Recommended service and pricing model
  3. 3.Clause 3

    Agreement & data processing terms

    If you decide to go ahead, we sign a service agreement and a full data processing agreement. Scope, fees, access, reporting and exit terms are written down before work begins.

    Party
    You and us
    Timing
    When you’re ready
    • 3.1Service agreement
    • 3.2Data processing agreement
    • 3.3Named contacts on both sides
  4. 4.Clause 4

    Recovery work

    We work the claims: correct, resubmit, appeal and follow up, starting with the highest value and nearest deadlines. Questions for your team are batched, not scattered.

    Party
    Us
    Timing
    Ongoing
    • 4.1Claim-level worklist you can inspect
    • 4.2One weekly batch of questions, at most
  5. 5.Clause 5

    Monthly reporting

    A one-page report of what was recovered, what is pending and what was closed and why, with the claim-level detail behind it.

    Party
    Us, to you
    Timing
    Every month
    • 5.1Recovered, pending, closed
    • 5.2Aging movement
    • 5.3What we’re changing next month

Clause 5, in practice

The report you get every month.

One page. Figures first, explanation second. The claim-level appendix is there if you want it.

  1. a.

    Recovered

    Paid into your account this month from claims we worked.

  2. b.

    Pending

    Corrected, resubmitted or appealed, waiting on the payer.

  3. c.

    Closed

    Not recoverable, with the reason recorded — so you know, rather than wonder.

Monthly recovery report

Sample Medical Centre

Reporting period: Month 6 · Amounts in billing currency

Sample data
Recovered
0.00
132 claims
Pending with payer
0.00
87 claims
Closed, not recoverable
0.00
19 claims

Recovered by week, thousands

8.2W111.6W29.4W313.1W45.9W5

Open claims by age — start → end of month

Open claims by age bucket at the start and end of the month
AgeStartEndChange
0–30 days212188-24
31–60 days141116-25
61–90 days9771-26
90+ days164109-55

Root causes of denials worked this month

  • Authorisation missing or expired41
  • Coding or modifier mismatch33
  • Missing documentation27
  • Eligibility not verified19
Page 1 of 1 · Appendix A: claim-level detail, 238 claimsPrepared by Solace Health
Sample data: a monthly report showing recovered, pending and closed amounts, weekly recovery, movement of open claims by age, and root causes of denials.

Reserved to you

What stays with you.

  • Your billing system and your data
  • Your relationship with patients
  • The right to revoke our access at any time
  • Decisions on write-offs above [[WRITE_OFF_APPROVAL_THRESHOLD]]

Clause 1 costs nothing.

Request a free claims audit

Questions first? Read the FAQ.