About
Insurance companies deny behavioral health claims at 85% higher rates than other specialties. Small practices lack the time and expertise to fight back. We built DenialFixer to change that.
The problem
A single appeal takes 30–45 minutes of staff time. Multiply that by 50–200 denials per month and most practices write off the revenue.
Yet 44% of appealed claims are overturned on the first attempt (KFF, 2023) — and that rate climbs to 76% when parity violations are cited. That gap represents tens of thousands per year in revenue practices are entitled to but never collect.
Our approach
We ingest denied claims, analyze the reason code, generate payer-specific appeal letters with clinical justification, and submit them on your behalf.
Routine denials are fully automated. Complex denials get AI-generated clinical arguments referencing payer policies, AMA guidelines, and applicable regulations like the Mental Health Parity Act.
Focus
85% higher than medical/surgical, driven by necessity and authorization requirements.
Many denials violate the Mental Health Parity Act. We know how to identify and appeal them.
Unique CPT codes (90834, 90837, 90847) and diagnosis requirements that generic tools miss.
Time-based services create unique denial patterns around visit limits and frequency.
Denial management companies focus on hospitals. Solo and small group practices are left behind.
Mental health utilization up 40%+ since 2020. More claims, more denials, more revenue to recover.
Compliance
Administrative, technical, and physical safeguards for all PHI.
Signed BAA with every practice before any data is shared.
Data encrypted at rest and in transit. Field-level encryption for sensitive identifiers.
Every PHI access logged with user, timestamp, action, and IP address.
Isolated practice data. You only see your own claims and appeals.
Only minimum necessary information is processed. No patient names stored in cleartext.
Roadmap
Start with a free denial audit. See exactly what you're leaving on the table.