Claimtive parses your 835 remittance files and uses AI to draft payer-specific appeal letters the same day denials arrive — without touching your EMR. Built for independent specialty practices with 1–5 providers.
No EMR changes · No IT project · 15-minute setup
Average claim denial rate for specialty practices in 2025 — up from 9% in 2022
Estimated annual revenue loss per provider from unresolved denials
Of physician practices say their billing and collections systems need an upgrade
The problem
Waystar, AKASA, and R1 RCM all require health system IT departments and six-figure minimums. Independent practices with 1–5 providers are left managing denials manually — the billing person appeals by hand and silently writes off anything that looks hard.
The average denial rate for specialty practices hit 12% in 2025. That's revenue you earned, sitting in payer accounts because you don't have the staff to fight for it.
How it works
Upload EDI 835 remittance files or connect via your existing clearinghouse. No EMR changes required.
AI extracts denial reason codes (CARC/RARC), payer, claim amounts, and root causes automatically.
LLM generates payer-specific appeal letters the same day the denial arrives — your biller reviews and sends.
Dashboard surfaces denial trends by payer, code, and provider so you can see revenue recovered over time.
The product
Ingest EDI 835 files from any clearinghouse and extract denial data in seconds, not hours.
Payer-specific appeal letters generated by an LLM trained on CARC/RARC denial codes and contract terms.
Flag claims likely to be denied before they go out, based on payer + procedure + diagnosis patterns. (Q4 2026)
Compare actual reimbursements against your contract terms and peer benchmarks to recover left-behind revenue.
Pricing
A 2-provider practice paying $400/month needs to recover roughly one additional claim per month to break even. The average spine/pain claim is $800–2,000+.
1 provider
2–4 providers
5+ providers? Talk to us about volume pricing. Billing companies serving multiple practices — contact us for white-label pricing.
We're onboarding a small group of independent specialty practices for our founding cohort. Setup takes 15 minutes. No EMR changes. No IT team required.
Limited spots · Pain management · Spine · Orthopedics · PT/OT