Your denials are recoverable revenue. Most practices never collect it.
Around 70% of denied claims are overturned when someone appeals them. The obstacle is never merit — it’s capacity. Vizora codes, submits, chases and appeals every claim, so the revenue you already earned actually arrives.
- No setup fees
- You pay when we collect
- 25 specialties supported
vizora · claims workspace
LIVE$0
Collected today
97%
Clean claim rate
24
Days in AR
Billing across every major payer
The real problem
Denials aren't a billing problem. They're a front-end problem.
Most practices work denials harder. The data says the leverage is upstream — nearly half of all denials are created before a claim is ever coded.
84%
of claim denials are potentially avoidable
44%
of denials originate at the front end
24.3%
of denials are registration and eligibility errors
What that looks like in a practice
Coverage is verified once at registration and assumed stable. Authorization is discovered to be required after the service is delivered. A claim rejects for a missing modifier and sits in a worklist nobody has time to open. Ninety days pass. Then it hits the filing deadline and becomes worth exactly nothing.
None of that is a coding failure. It’s a capacity failure — and it compounds quietly, because a denial that is never worked never shows up as a loss.
Denials written off unworked
The revenue was collectible. Nobody had time.
AR aging past the filing deadline
Past the payer's window, recovery probability is zero.
Systematic undercoding
Documentation supports more than what gets billed.
The lifecycle
Four places revenue leaves, and what closes each one
Every dollar a practice loses exits at one of four points. None of them are visible in a standard collections report.
Before the visit
Coverage assumed rather than verified
Eligibility is checked at registration and treated as stable. Plans change mid-year, secondary coverage goes unrecorded, and authorization requirements surface only after the service has been delivered and the cost already incurred.
24.3%of denials are registration and eligibility errors
At coding
Documentation that understates the work
Undercoding produces no denial, no alert and no report line. A provider audited once tends to down-shift permanently, and without periodic coding review nothing in the practice ever notices the gap between what was done and what was billed.
At submission
Claims that never reach the payer
A claim rejected at the clearinghouse exists in your system as submitted and in the payer's system not at all. It appears in no aging report built from payer data, and it ages silently until the filing deadline closes.
After denial
Appeals nobody has capacity to file
Roughly 70% of appealed denials are overturned and paid. The constraint is almost never the merits of the claim — it is whether anyone has the hours to work the queue before the payer's appeal window expires.
~70%of appealed denials are overturned
Claim lifecycle
Five stages, four leak points
- 1
Eligibility
24.3% of denialsCoverage and benefits verified before the visit
- 2
Coding
Undercoding — silentDocumentation translated by a specialty-assigned coder
- 3
Scrubbing
Cheapest fix pointChecked against payer-specific and NCCI edits
- 4
Submission
Silent rejectionsTransmitted electronically, acknowledgements read daily
- 5
Payment
UnderpaymentsPosted, reconciled, and variances challenged
Free tool
What are denials costing your practice?
Enter your numbers. The calculation uses published MGMA, Premier and Optum benchmarks — sources shown.
Across all providers
Allowed amount, not billed charge
First-pass denials, if known
Estimated annual revenue at risk
$190.1K
From roughly 864 denied claims a year. Around $133.1K of that is typically recoverable on appeal — and about 726 of those denials were avoidable in the first place.
- Recoverable on appeal
- $133,056
- Annual cost just to rework them
- $49,447
Takes 2 minutes. No sales pitch.
Method: denied claim volume × average claim value. Recovery applies Premier Inc.’s finding that ~70% of denied claims are overturned when appealed (2023); rework cost uses Premier’s $57 per contested claim; the avoidable share uses Optum’s 84% figure (2023). This is an estimate for orientation, not a quote — a billing audit measures your actual numbers.
How it works
A transparent process, not a black box
You keep full visibility into your revenue cycle. Outsourcing the work shouldn't mean losing sight of it.
Free billing audit
We review your denial rate, AR aging, clean claim rate and payer mix against industry benchmarks — and tell you what we find, whether or not you hire us.
Practice onboarding
We learn your systems, workflows, payers and specialty requirements, then configure around them. Typically under 2 weeks, with no interruption to your claim flow.
Claims and follow-up
We code, scrub and submit claims, work the payer queue, and appeal denials instead of writing them off.
Monthly reporting
Transparent reporting on collections, denials by reason and payer, and AR aging — with the specific fixes that will move your numbers.
What we do
Twelve services covering the whole revenue cycle
Take the whole cycle or the piece that's failing. Most practices start with denial management or AR recovery.
Specialty expertise
Your specialty bills differently. Your coders should too.
Cardiology component splits, behavioral health carve-outs, the podiatry routine foot care exclusion — general-purpose coders miss all of it. Ours are assigned by specialty.
Results
What changed for these practices
“Vizora transformed our billing process. Our denial rate dropped from 28% to under 8% in just three months, and cash flow improved significantly.”
“The transparency and communication are excellent. Monthly reports give us clear visibility into our revenue cycle, and their team is always responsive.”
“Since partnering with Vizora, we've recovered over $150K in previously denied claims. Their denial management expertise is outstanding.”
Pricing
3% of collections. You pay when we collect.
Pricing starts at 3% and typically runs 3–6% of net collections depending on practice size, specialty and claim volume. No setup fees, no charge for denial appeals, and no long-term lock-in.
For comparison: one in-house biller costs roughly $73,000 a year fully loaded — before billing software, clearinghouse fees, training, or coverage while they’re on leave.
Included at no additional cost
- Denial appeals and rework — always included, never billed separately
- Year-end billing and compliance audit
- Real-time eligibility verification
- Monthly reporting and performance review
- Dedicated billing specialist you can reach directly
- Client portal with live claim status
We don’t charge separately for appeals. Charging per appeal creates an incentive to generate denials, which is exactly the wrong alignment.
Questions
Frequently asked questions
More detail on the full FAQ page, or ask us directly.
Within 2 weeks
Typical onboarding
Vizora charges a percentage of net collections, starting at 3% and typically ranging from 3% to 6% depending on practice size, specialty and claim volume. You pay only when we collect. There are no setup fees and no hidden charges. For comparison, one in-house biller costs roughly $73,000 a year fully loaded before software or management overhead.
For physician practices, MGMA reports an aggregate first-submission denial rate of 8%. Hospitals and health systems run higher — Kodiak Solutions measured 11.81% in 2024. Experian Health found 41% of providers now report denial rates above 10%, up from 30% in 2022. If you are above 10%, there is recoverable revenue in your denials.
Typically within 2 weeks depending on practice size and complexity, covering credentialing verification, system integration, historical data migration and staff training. We sequence onboarding so your existing claim flow is never interrupted.
No. We work inside your existing systems. If your current software is genuinely limiting collections we will tell you and quantify it, but migration is never a precondition of working with us.
Start at the front end. Optum found 44% of denials originate in front-end processes, with registration and eligibility errors alone accounting for 24.3% — the largest single category. Verifying eligibility before the visit, confirming authorization requirements, and scrubbing claims pre-submission prevent more denials than any back-end process.
Yes. We operate under HIPAA safeguards including encrypted data transmission and storage, role-based access controls, staff training and access logging. A Business Associate Agreement is available on request and should be executed before any protected health information is exchanged.
Find out what your denials are costing you
A free billing audit reviews your denial rate, AR aging and clean claim rate against industry benchmarks. Takes about two minutes to request. No sales pitch.
No setup fees · You pay when we collect · Pricing from 3% of net collections