Most tools flag the denial.
Ours fights it to the end.
Incerto's AI agents draft the appeal, submit it, track the payer's response window, and escalate to a Level 2 appeal or IDR when they don't budge. Built only for ASCs. You pay only when we recover.
No commitment. We sign an NDA and show you the dollar amount first.
Denial rates are climbing in the specialties nobody's watching.
Ortho gets the attention. But look at first-submission denial data across 590+ ASCs and nearly 3 million cases, and the specialties moving in the wrong direction are the ones with the least denial-management focus.
60% of denied claims are never reworked at all. The ones that are cost $25 to $181 each to fight. Payers aren't betting they'll win the appeal. They're betting you won't file it.
— Premier Inc., 2024 Denials Report
Sources: HST Pathways, ASC Industry Trends (590+ ASCs, ~3M cases, 2023–2024); Premier Inc., 2024 Denials Report; KFF, Medicare Advantage 2024 Spotlight on Prior Authorization.
Five steps. None of them wait on your staff's bandwidth.
Every denial, triaged automatically.
Claims are categorized by payer, reason code, and dollar value the moment the remit posts. Nothing waits in a shared inbox.
A payer-specific appeal, drafted in minutes.
Grounded in the exact LCD, payer policy, and clinical documentation for that denial type. 2 minutes average, not 2 hours.
Submitted, then tracked around the clock.
The agent watches the payer's response window and follows up the moment it lapses, by call or email.
Escalated when payers stall.
A Level 2 appeal, peer-to-peer request, or IDR filing goes out automatically when the first response isn't enough.
Root cause, fed back.
Every resolved denial updates the pattern library, so the same payer and code combination gets caught before it's denied again.
Hard numbers.
Not estimates.
From Incerto's own deployment data. See the full case study below.
One modeled $5M ASC, one 90-day window.
We ran the leak points against a representative mixed-specialty ASC: $5M revenue, 3 surgical suites, 10 surgeons, a GI/ortho/ ophthalmology/ENT/pain mix. In 90 days, denials alone cost it $118,000.
Illustrative model built from HST Pathways, Premier Inc., and KFF data across the specialty mix described. Not a specific client's audited results.
Not another "AI reduces denials by X%" claim.
Built only for ASCs.
Facility fees, implant carve-outs, OON gap billing, ASC-specific LCDs. Not inpatient DRGs repurposed for outpatient.
Follows through, not just flags.
Submits, tracks, escalates, files Level 2 and IDR automatically. Most tools stop at the appeal letter.
Institutional memory that doesn't quit.
Every payer pattern the agent learns stays when your billing manager doesn't.
Paid on recovery, not on seats.
No monthly fee, no setup cost. A percentage of what we actually collect.
Seen in the field.
Real claims. Real numbers.
If we don't recover,
you don't pay.
No monthly fees, no seat licenses. We work on contingency — our incentive is aligned with yours. We get paid a percentage of what we actually collect.
Book a free assessmentNo commitment. We show you the number first.
We show you the number.
Then you decide.
No sales deck. No demos of features you haven't asked for. Just an honest look at what's recoverable in your current claims data.
Send us a sample of recent denied claims.
30–90 days of denial data is enough. We sign an NDA before you send anything.
We run our AI analysis.
Within a few days, our AI agents analyze your patterns and show you exactly which categories are leaking and how much is recoverable.
You see the number.
Hard dollar estimates, not percentages. Then you decide if you want to work together.
You'll speak with someone who has worked real RCM workflows. Not a sales rep.