Denials & appeals
We work denied and underpaid claims — including the medical-necessity and level-of-care denials generalist billing shops fumble — and appeal them before they age out.
Behavioral health revenue recovery
You delivered the care.A chunk of the money never came.
Recoup recovers the revenue behavioral health facilities lose to denied continued-stay authorizations, concurrent reviews that slipped, and claims that aged past timely filing. We work on contingency — so finding out what you’re owed costs you nothing.
Show me what we’re owed
Send your aging report. We’ll show you what’s recoverable — free, no obligation.
| Bucket | Balance |
|---|---|
0–30 days | $312,400 |
31–60 days | $184,900 |
61–90 days | $96,250 |
91–120 daysaging out | $71,800 |
120+ daysaging out | $128,400 |
Sitting past 90 days$200,200
Illustrative figures. Your teardown reads your real aging report.
The problem
None of this is a clinical problem.
You know the pattern. A patient steps down from residential to PHP, the continued-stay authorization gets denied, and the days they were already in care turn into a write-off. An appeal sits in a queue until it ages past the filing window. A claim stalls behind a verification error nobody caught. Your billing team spends its afternoons on hold with payers instead of working the next case.
The care happened. The notes are there. The money just never made it back to you — and most facilities can’t even say how much.
Where it leaks
- Continued-stay and concurrent reviews denied for “medical necessity” you can defend
- Appeals that never got worked because no one had the hours
- Claims that aged past timely filing and quietly became write-offs
- Eligibility and benefit-verification errors that sink a claim before care even starts
- Billing and UR staff burning out on portals and hold music
If you can see the leak but can’t point to where it’s coming from, that’s the first thing worth fixing.
What we do
We work the gap between care delivered and money collected.
Three places the money leaks — and the three we go after.
Authorizations & utilization review
We stay on top of initial auths and the continued-stay and concurrent reviews that decide whether the care you’re already delivering gets paid.
Eligibility & benefits
We catch the verification and benefit errors that quietly kill a claim before the first session ever happens.
We do this across the systems you already run. Nothing to install, nothing for your staff to learn.
How it works
What working with us actually looks like.
- 1
Send your aging report.
That’s the whole ask to get started. We’ll tell you exactly what to pull.
- 2
We find the leak.
We go through it and show you what’s recoverable and why it’s been sitting there — in plain dollars, not a dashboard you have to decode.
- 3
We work it.
We pursue the recoverable claims across your existing systems, and keep your team out of the portal-and-hold-music loop.
- 4
You get paid.
You pay us only out of what we actually recover.
No risk to find out
We get paid only when you do.
Recoup works on contingency. We take a share of what we recover for you — and nothing if we recover nothing. No setup fee. No monthly software cost. No upfront commitment to find out how big your leak is.
The worst case is that you learn exactly where your money has been going. The likely case is that we find revenue you’d already written off.
Why we built Recoup
We came up inside the billing that’s losing you money.
Recoup was built by people who came up inside behavioral health billing — the EHRs and revenue-cycle systems these facilities run on, and the payer logic that decides what actually gets paid. We’ve watched the same denials repeat, the same continued-stay auths get fumbled, and the same dollars go quiet in the aging report.
That’s why we know where to look first — and why generalist billing shops keep missing it.
We’re a new firm, and we’d rather be straight about that than dress it up. Here’s what makes us easy to try: we only get paid when you do. Start with a teardown and judge us on what we find.
- Contingency
- We earn only when you collect — no setup fee, no monthly cost.
- No switching
- We work on top of your current biller and EHR. Nothing to install.
- HIPAA-aware
- Your aging report moves over a secure, BAA-covered channel — never this site.
Where this is going
Recovering your money is step one.
Working your claims produces something most facilities have never actually had: a clear, current picture of where their revenue goes.
“Where am I losing the most money right now?”
That’s what we’re building toward — a way to ask your revenue cycle a plain question and get a straight answer back. Running the business with the lights on, instead of guessing.
We’ll get there with the facilities we recover for first. Recovery proves it out. The visibility is where it leads.
Questions
Questions you’re probably asking.
Do you only get paid if you recover money?
Yes. Recoup works on contingency — we take a share of what we actually recover for you, and nothing if we recover nothing. There’s no setup fee, no monthly software cost, and no upfront commitment to find out how much you’re owed. The teardown that shows you the leak is free.
Do I have to switch my EHR or replace my current biller?
No. We work across the systems you already use and layer on top of your current setup. There’s nothing to install and nothing for your staff to learn. We go after the denials, authorizations, and aged claims slipping through — alongside whatever biller or platform you already run.
What happens in a free aging-report teardown?
You send your aging report. We go through it and come back with a straight read on what’s recoverable, where it’s stuck, and what it would take to collect it — specific to your numbers. It’s free and carries no obligation. If there’s nothing worth recovering, we’ll tell you that too.
Can I still recover a behavioral health claim that’s past timely filing?
Often, yes. Timely-filing denials can frequently be appealed when you can document timely submission, a payer error, or another valid exception — but the window to act is short. The older a claim gets, the harder recovery becomes, which is why aged AR is usually the first thing we work.
Why do behavioral health claims get denied more often than medical claims?
Behavioral health carries a heavier authorization burden — continued-stay and concurrent reviews, medical-necessity criteria like ASAM, and level-of-care rules across PHP, IOP, residential, and detox. Each is a point where a payer can deny care you’ve already delivered, and generalist billing shops routinely miss these BH-specific steps.
What is a concurrent (continued-stay) review, and why did mine get denied?
A concurrent or continued-stay review is the payer’s mid-treatment check on whether ongoing care still meets medical necessity. Denials usually turn on documentation and which criteria were applied (ASAM, MCG, or the payer’s own). Many are defensible on appeal when the clinical record is presented against the right standard.
How does mental-health parity (MHPAEA) help me appeal a denial?
Parity law requires behavioral health benefits be no more restrictive than medical and surgical ones, which can be grounds to challenge a denial. Note: as of May 2025, regulators paused enforcement of the 2024 Final Rule’s new provisions — but the underlying parity statute and 2013 rule remain in force.
What’s the difference between a behavioral-health biller and a generalist RCM company?
A generalist handles claim volume; a behavioral-health specialist knows where BH revenue actually leaks — concurrent review, medical-necessity denials, level-of-care and per-diem billing, and BH carve-outs. We came up inside behavioral health billing, so your payers and denial patterns aren’t a learning project for us.
What share of claims actually get denied — and appealed?
Denials are common and badly under-worked. According to KFF, roughly 19% of in-network ACA marketplace claims were denied in 2024, yet fewer than 1% of denials were appealed. Most denied dollars are simply written off — which is exactly the gap Recoup exists to work. (KFF, 2024)
Which facilities is this for?
PHP, IOP, residential, and detox programs — the levels of care where dollars per case are high and the authorization burden is heaviest. If you’re running one of these and watching denied continued-stay auths and aged claims pile up, that’s exactly the leak we work.
The teardown
Find out what you’re leaving on the table.
Send us your aging report. We’ll come back with a straight read on what’s recoverable, where it’s stuck, and what it would take to get it back — specific to your numbers. It’s free, and you’re under no obligation to do anything with it. If there’s nothing worth recovering, we’ll tell you that too.
Prefer to talk first? or email us.