Revenue cycle management for independent practices
Billing that chases
every denied dollar,
not just the big ones.
Ivera is a revenue cycle management company for independent practices. We run billing end to end: eligibility, authorizations, scrubbing, submission, posting, follow up and the monthly close. At the core is a denial recovery engine that reads every remittance line and files the appeal the moment you approve. For every new practice it starts on the denied backlog first, free.
- Free backlog cleanup when you switch
- BAA before any data moves
- No retainer, month to month
Claim IVMDEMO41KX2A8
Jordan R. · Wellpoint TX · week of Sep 1
Denial read from the 835
CO-197 · 97153 · 8 units · $160.00
Appeal drafted with the note
Authorization A-1 attached · 2s
Approved by the practice
One click from the desk
Filed on the payer portal
Case 500118274 · tracked daily
Payer re issued
$116.00
Posted to the ledger
cheque 6610004498
- claims processed
- 500,000+
- appeals filed with the payer
- 20,000+
- practices served, across specialties
- 56
- recovered from appeals
- $3,000,000+
Payers we file with
- Aetna
- UnitedHealthcare
- Cigna
- Anthem
- Blue Cross Blue Shield
- Humana
- Optum
- Carelon
- Magellan
- TRICARE
- Medicare
- Medicaid managed care
- Molina
- Centene
- Kaiser Permanente
- Oscar
Systems we read from
- CentralReach
- Theralytics
- SimplePractice
- TherapyNotes
- WebPT
- Prompt
- Raintree
- Tebra
- athenahealth
- AdvancedMD
- eClinicalWorks
- DrChrono
- Kareo
- Office Ally
- Availity
- Waystar
- Change Healthcare
- Stedi
Names belong to their owners. Ivera is not affiliated with or endorsed by any payer or software vendor listed.
Billing as usual
Most billing does not lose money loudly. It loses it one small line at a time.
In house or outsourced, the model is the same: submit, post what the payer sends, and work the denials there is time for. Three things follow from that.
01
Denials are triaged by size
An appeal takes a biller twenty to forty minutes. With a few hours a week for them, the $400 claims get worked and the $58 lines get written off. In ABA, therapy and primary care, most denied dollars sit in lines under $100.
02
Written off means gone
A denial posted as an adjustment leaves accounts receivable. Your aging report shows the claim closed. From that moment nobody is responsible for the money, because it no longer appears anywhere.
03
You cannot see what was done
A monthly summary gives you collections and a denial rate. It does not say which claims were appealed, what the payer answered, or what was quietly dropped. Switching feels risky because the current state is a black box.
With Ivera
The same revenue cycle, run so that nothing is allowed to disappear.
- Every remittance line is classified and priced, so no denial is too small to have a number on it.
- Denied money stays open in AR until a person works it or writes it off on the record, with a name next to it.
- Every action is a ledger entry you can open, from the first claim of the backlog cleanup onward.
The platform
Everything between the session and the deposit.
One ledger, one set of rules, one place to see where every dollar is. Your EHR stays the source of sessions and notes. Ivera owns the claim, from eligibility to the deposit.
- 01Live
Eligibility
270/271 checks before each authorization period and monthly, so an inactive policy is caught before the session, not after the denial.
- 02Live
Authorization tracking
Units approved, used and remaining per code. Warnings when an auth expires, runs out at the current pace, or a week breaks its cap.
- 03Live
Claim scrubbing
Every hold says who fixes it: the practice or Ivera. Credentials per code, modifiers, timely filing, payer rules, duplicates.
- 04Live
Submission
837P claims with a control number on every line, acknowledgements read automatically, front door rejections on a queue with the reason in plain words.
- 05Live
Payment posting
835 remittances post into an append only ledger. Reversals, re issues and provider level adjustments balance to the cent.
- 06Live
Denial recovery engine
Reads every remittance line, drafts the appeal with the clinical note, files after you approve, tracks the case to the re issue.
- 07Live
Secondary billing
When the primary leaves a balance and the patient has another plan, the secondary claim is built with the primary's adjudication inside it.
- 08Live
Accounts receivable
Every open balance with one next action: status inquiry, call the payer, work the denial, bill the secondary, send the statement.
- 09Live
Patient statements
Statements that show what insurance paid and adjusted, with a payment link. Payments apply oldest service first.
- 10Live
Monthly close
Charges, collections, adjustments, AR aging, days in AR, clean claim rate and denial rate, computed from the ledger every time.
- 11Live
Underpayment detection
Paid amounts compared to your contracted fee schedule, line by line, so a short pay is worked like a denial.
- 12In development
Payer calling agent
A voice agent for the calls EDI cannot replace: reprocessing requests, reference numbers, claims the payer says it never received.
The agents
Six agents work the queue. You approve what leaves.
Each one does a narrow job it can be checked on. Nothing is filed in your name until a person at the practice says yes.
Detect
classifies every 835 line into a denial type and prices the denied units at your contracted rate.
Draft
writes the appeal with the clinical note and the payer's own policy, ready for one click approval.
File
submits on the payer portal, captures the case number, and retries when the portal flakes.
Watch
tracks claim status and pairs reversals with re issues so an overturn is counted once.
Post
lands every remittance in the ledger and raises an exception rather than guessing.
Scrub
holds a claim before it leaves and tells the right person what to fix.
Everybillingcompanysaysitpreventsdenials.Iveraalsogoesbackforthemoney,oneremittancelineatatime,includingthe$60onesnobodyhasanafternoonfor.
- CO-22Coordination of benefits
- CO-197Authorization missing
- CO-252Documentation requested
- CO-256Contract and rate
- CO-96Non covered service
- CO-50Medical necessity
- CO-4Modifier inconsistent
- CO-97Bundled into another service
- CO-18Duplicate claim
- CO-29Timely filing
- CO-16Information missing
- CO-45Above contracted rate
- PR-96Patient responsibility, non covered
- CO-151Units above frequency limit
- CO-109Wrong payer
- Short payPaid under the fee schedule
The denial recovery engine
Where the platform earns its keep.
Most vendors stop at prevention and call denial work “follow up.” This is a recovery system: it has filed 661 appeals for one practice and shows you each one.
- 01
Reads every remittance line
Not the claim total. Each service line, with its own adjustment codes, remark codes and units, classified into a denial type: coordination of benefits, authorization, medical necessity, documentation, contract, non covered, duplicate.
- 02
Prices what was denied
Denied units times your contracted rate, so a $64 line and a $640 line are both real money with a number on them, and nothing is dismissed as noise.
- 03
Drafts the appeal with evidence
The clinical note, the authorization, and the payer's own rule, assembled into the appeal. Second denials are escalated, not re sent.
- 04
You approve, the engine files
One click on the approval desk. The agent submits on the payer portal, captures the case number, and retries when the portal fails.
- 05
Follows the money to the re issue
An overturn arrives as a reversal plus a new payment on a new claim number. The engine pairs them, so recoveries are counted once and never missed.
- 06
Bills the interest you are owed
Where state prompt pay law adds interest to a late clean claim, the engine bills it on every recovery it makes.
Recoverable surfaced for one practice
$45,697
Across 2,954 classified remittance lines. By denial type:
- Coordination of benefits$15,465178 lines
- Contract and rate$11,66593 lines
- Non covered service$9,632184 lines
- Documentation requested$8,935161 lines
Live production figures, October 2026. The practice approves every appeal before it is filed.
The process
Watch one claim go through.
The same flow the approval desk shows your team: a real denied line, read, priced, appealed, approved by you, filed, and posted back to the ledger when the payer re issues.
Ledger · Jordan R. · week of Sep 1
RecoveredPosted to the practice
$116.00
Counted once. Reversal and re issue paired.
- 01
- 02
- 03
- 04
- 05
Free backlog cleanup
We work your old denials first. That part is free.
When a practice moves its billing to Ivera, the engine starts with the remittances you already have, not the next claim. Everything still inside the payer's appeal window gets read, priced and worked: denied, underpaid, written off, posted as an adjustment. What the backlog returns is yours. We do not take a share of it.
Why free: it is money a regular biller would have left behind, it shows you what the engine does with your own payers before you trust it with new claims, and for most practices it means the switch has paid for itself before the first new claim goes out. Keeping your biller? The same cleanup runs on contingency instead: a share of what we recover, nothing otherwise.
One practice's backlog, before any new claim was billed
$45,697
recoverable across 616 remittance lines
661 appeals have been filed from it since, each with a payer case number.
- Coordination of benefits$15,465178 lines
- Contract and rate$11,66593 lines
- Non covered service$9,632184 lines
- Documentation requested$8,935161 lines
“Ivera got us five figures back to our pockets with the backlog cleanup.”
- 97153 · 8u · CO-197Authorization$116.00Appeal drafted
- 97155 · 4u · CO-252Documentation$87.00Note attached
- 90837 · 1u · CO-22Coordination of benefits$132.40Primary confirmed
- 97153 · 12u · CO-256Contract$174.00Rate dispute filed
- 97156 · 2u · CO-96Non covered$58.50Policy cited
- 99214 · 1u · CO-4Modifier$94.12Corrected claim
- 97151 · 6u · CO-97Bundled$211.80Appeal drafted
- 90834 · 1u · CO-18Duplicate$98.00Status checked
- 97153 · 8u · Short payUnderpayment$23.20Rate dispute filed
- 97158 · 3u · CO-50Medical necessity$64.50Note attached
- 01Send what you haveRemittances, an aging export, or a clearinghouse login. Nothing to install and nothing for your staff to learn.
- 02See the number in 24 hoursWhat is recoverable, by payer and denial type, and how much of it is still inside the appeal window.
- 03Approve, and watch it landYou approve each appeal, the agents file and follow up, and every recovery posts to the ledger reconciled to the cheque.
Appeal windows vary by payer, commonly 90 to 180 days from the remittance. The sooner the backlog is read, the more of it is still reachable.
Results
One practice, every number traceable.
An ABA practice handed Ivera an aging report and a clearinghouse login. Below is what the engine has done since, read from production rather than a slide. Ask on the call and you can speak to them.
Overturn rates vary by payer and denial type, so we do not print one number for them. The review shows you yours, payer by payer.
- 1,407
- claims taken on, from a single aging report
- 661
- appeals filed, each with a payer case number
- 250
- claims closed as recovered
- 47 of 47
- payer cheques reconciled to the cent
Live production figures, October 2026.
From clients
What practices say once the money starts landing.
Ivera got us five figures back to our pockets with the backlog cleanup.
Gal is very professional and nice, handles everything correctly.
Gal is always available to me, responds quickly, and makes sure to fix anything I ask him as soon as possible.
From current Ivera clients. Practice names withheld.
Against the category
What you will not find on the other sites.
We read them so you do not have to. The pattern is prevention up front, a sales call for the price, and silence on appeals.
Appeals
Filed, tracked to the re issue, counted on this page
Listed as “denial follow up”
Denied money
Stays open in AR until a person works it or writes it off
Posted as an adjustment and gone
Pricing
4% of collections, 25% of recoveries, on this page, month to month
Behind a demo call
Practice size
No minimum. One provider is enough
Entry tiers from $2,500 a month
Your numbers
Every figure is a ledger entry you can open
A dashboard
What gets filed
Nothing, until the practice approves it
“High confidence” auto corrections
Pricing
You pay when the money lands.
Two ways to work with Ivera, both priced here rather than on a sales call. Both start with the same free review of your denials, and both are put in writing before a claim is touched.
Keep your biller
Denial recovery
25%of what we recover
Nothing upfront, nothing if we recover nothing.
- Free review of your denials in 24 hours
- We work every recoverable line, you approve each appeal
- Statutory interest billed to the payer where your state allows
- No retainer, no minimum, month to month
Ivera runs billing
Full revenue cycle
4%of commercial insurance collections
Flat fee per claim on Medicaid, as the rules require. Denials and appeals are included, never billed separately.
- Your denied backlog worked first, nothing charged on what it returns
- Eligibility, authorizations, scrubbing, submission, posting, follow up
- The denial engine on every claim, inside the 4%
- Monthly close report and an AR worklist you can read
- Any size practice, no minimum
Security
Built to be checked.
01
BAA before any data moves
HIPAA eligible infrastructure on AWS, FIPS validated encryption in transit and at rest, PHI deleted on exit per the agreement.
02
An audit trail that cannot be edited
The ledger and the audit tables are append only and hash chained. A correction is a new entry, never a rewrite.
03
A person approves every filing
Appeals and claims leave in your name only after someone at the practice says yes. Declining is one click.
04
Scoped by practice, always
Every query is tenant scoped and row level security is enforced in the database, not only in the application.
Common Questions
Questions before you start your audit.
Everything you need to know before uploading your first remittance file.
Is this HIPAA safe? Do you need patient data to run my review?
No PHI is required for the review. We work from claim metadata only: claim ID, denial code, dollar amounts, payer, CPT, dates. No patient names, no dates of birth. Strip those before you send and there is nothing protected in the file. Ivera runs on AWS HIPAA eligible infrastructure with FIPS validated encryption in transit and at rest, and we sign a BAA before any PHI moves for the recovery work.
Do I have to switch billing systems or change my EHR?
No. Your EHR stays the source of sessions and notes. For denial recovery we work from a redacted export of what you already use. For full revenue cycle management we take a sessions export on a schedule and own the claim from there. Nothing to install, no migration, no new login for your staff.
What is the difference between denial recovery and full revenue cycle management?
Denial recovery sits beside your current biller: we take the denied and underpaid lines, appeal them, and get paid only on what we recover. Full revenue cycle management means Ivera runs billing end to end, from eligibility and authorizations through claim submission, payment posting, follow up and the monthly report, with the same denial engine working every claim. Both start with the free review.
What is the free backlog cleanup?
When you move your billing to Ivera, the engine works your existing denied and underpaid claims before it bills anything new: everything still inside the payer's appeal window, including lines that were written off or posted as adjustments. You keep all of it; Ivera does not take a share of backlog recoveries for full revenue cycle clients. For one practice that backlog came to $45,697 recoverable across 616 remittance lines before a single new claim went out. If you are keeping your current biller, the same cleanup runs on contingency instead.
What if you find nothing, or recover nothing?
Then it costs you nothing. The review is free, and denial recovery runs on contingency at 25% of what we recover: we get paid when you do. If we do not recover money for you, you do not pay.
How fast is the first review?
24 hours. Send the redacted export and you get your numbers back the next day: the total recoverable, the small dollar write offs you are not tracking, and a payer by payer breakdown. The fastest path is to book a call and we walk you through it live.
Is a human in control of what gets filed?
Always. You approve every appeal and every claim before it is filed, one click from your dashboard. The engine detects, drafts and submits, but nothing goes to a payer in your name until you sign off. You can decline any of them.
What do the agents actually do, and what is still being built?
Six agents run today: one classifies every remittance line, one drafts the appeal with the clinical note, one files on the payer portal and retries when it fails, one tracks status and pairs reversals with re issues, one posts remittances into the ledger, and one holds a claim before it leaves and says who needs to fix it. A voice agent for the calls EDI cannot replace is in development. We label each of these honestly on the platform section.
My team already appeals some denials. What do you actually add?
We catch the ones they cannot get to. Billers triage the big, obvious denials and run out of hours, so the $60 and $90 lines quietly get written off. Those add up to most of the leak. The engine works every recoverable line, prices each one at your contracted rate, and never silently writes a denial off: it stays open in AR until a person decides.
How is the full revenue cycle service priced?
4% of insurance collections on commercial payers, with denials and appeals included rather than billed separately. On Medicaid and Medicaid managed care it is a flat fee per claim, because federal rules do not allow a percentage there; that figure depends on your volume and is set after the free review. Everything is put in writing before any claim is touched, and there is no minimum practice size.
What is the contract length?
There is not one for denial recovery: month to month, no annual commitment, no minimums, no early termination fee. Full revenue cycle agreements are written with a notice period and run out terms so your cash flow never gaps during a change.
What happens if I cancel?
Give notice and we wind down. You keep every dollar already recovered, we hand back your patients, claims, payments and open balances in a standard format, and we delete PHI on our side per the BAA. No clawback, no exit fee, no data held hostage.
Free denial review
Send the export. Get your numbers back in 24 hours.
A redacted claims or remittance export is enough. The engine reads every line, prices what is recoverable at your contracted rate, and we walk you through it payer by payer on a short call. Whether you want denial recovery alone or Ivera running your whole revenue cycle, this is where both start.
Step 1 of 3
Who should we send the numbers to?
Four fields, then pick a time.