The $499 pilot design
Six decisions, written down, before the first packet.
The brief a managed pilot runs on. Delivered within five working days of payment and credited against the first month. If you decide not to run the pilot, you keep it.
The design is the written brief a managed pilot runs on. It costs $499, is delivered within five working days of payment, and is credited against the first month of a managed pilot started within 90 days. If you decide not to run the pilot, you keep the brief. It has six sections, and each one is a decision written down so nobody has to make it again in week three.
1. The queue
Which denials, from which payers, for which services. Where they arrive today, who sees them first, and what happens to the ones nobody appeals. The design names one queue; a second one is earned by the first invoice.
2. The owner
One person at the practice who owns the queue and one clinician who reviews. Their names, what they can decide alone, and what they escalate. The pilot has one reviewer on your side and one operator on ours.
3. The approval gate
What the reviewer sees before anything is submitted, what "approve", "approve with a correction" and "reject" mean for this queue, and who submits to the payer after approval. Nothing goes to a payer without an approval on the record.
4. The exception path
What the employee does when the chart excerpt is missing, the payer policy cannot be found, the denial is out of scope, or the deadline is inside 48 hours. Each case has a named owner and a written next step.
5. Baseline volume
How many denials the queue sees a month, how many are appealed today, how many of those win, and how long each takes. Where the practice has the numbers we use them; where it does not, we count the first month and write that down as the baseline. This is the number the 400-item bundle is checked against.
6. The scorecard
The pilot is judged on figures that come from its own sealed record, not from a slide:
- Completed items: packets approved, with or without a correction.
- First-pass approval rate: approved without a correction, as a share of all decided items.
- Corrections in force: rules your reviewer has written that every later packet must cite.
- Rejected items: recorded and never charged.
- Turnaround: time from the item entering the record to the reviewer's decision.
- Items beyond the bundle: completed items past the 400 included, at $6 each.
Appeal outcomes from the payer are recorded when the practice reports them; we do not claim a win rate we did not record.
What we need from you
- A 30-minute call with the queue owner and, if possible, the reviewing clinician.
- Three to five recent denials with the patient identifiers removed, so the brief is written on your payers and your services.
- If the pilot will touch patient data, a signed Business Associate Agreement before the first item. How data moves is on the security page.
What happens after delivery
You read the brief, we hold a 30-minute call, and you decide. Start the managed pilot within 90 days and the $499 is credited against the first month. Decide not to, and the brief is yours, with no further obligation.
Buy the design for $499