Independent revenue recovery review · UAE clinics
We review claims your current process has already handled, identify recoverable denials, short-payments and write-offs, and pursue the ones worth recovering.
Your team, RCM provider and systems stay unchanged.
Historical claims, denials and payments.
Performance fee on verified incremental collections.
A read-only export of historical claims, denials, remittances and resubmission history. No integration project, no access to your live systems, and nothing for your billers to learn or adopt.
The baseline is agreed in writing before any work starts, and we separate genuine recovery from ordinary growth, price changes and volume shifts. Insurer payments continue going directly to you.
Databases, processing, model inference and backups all sit in-country on infrastructure we control. Claims data is never sent to a public AI service.
One ledger. What appears recoverable, what it is worth, and the evidence behind each line. You read this before deciding whether to continue.
| What we found | Potential recovery |
|---|---|
| Denials never worked | AED 508k |
| Claims paid short | AED 292k |
| Filing-window risk | AED 220k |
| Repeat preventable rejections | AED 164k |
| Other | AED 57k |
| Total | AED 1.24m |
| What we found | Claims | Gross exposure | Est. recovery rate | Potential recovery |
|---|---|---|---|---|
| Denials never worked | 634 | 820,000 | 62% | 508,000 |
| Claims paid short | 411 | 530,000 | 55% | 292,000 |
| Filing-window risk | 192 | 310,000 | 71% | 220,000 |
| Repeat preventable rejections | 286 | 245,000 | 67% | 164,000 |
| Other | 173 | 190,000 | 30% | 57,000 |
| Total | 1,696 | 2,095,000 | — | 1,241,000 |
Assumptions. Recovery rates shown are estimates, not predictions. Short-payment variance is directly observable from remittances. Appeal-success rates depend on payer, denial reason and how much of the filing window remains — and on a first review they are informed assumptions, stated as such. Figures above describe a 12-month window of 4,412 claims and do not describe any specific clinic.
Because “processed” does not always mean “fully collected.”
A denied claim is visible. A short-paid claim may simply be marked paid and closed.
An appeal may be technically possible but not economical for a human team to investigate.
A repeated payer pattern may only become obvious across hundreds of claims.
We do not assume your team made mistakes. We apply a second analytical pass to transactions that already moved through the normal process.
A claim is billed at AED 4,800 and reimbursed at AED 4,100. The payment posts, the claim is marked complete, and the file closes.
The remaining AED 700 never becomes a task, because nothing in the process has a reason to raise one. On a single claim that is hard to spot. Across four hundred claims with the same payer and procedure family it becomes a contract issue.
A billing operation is measured on throughput and has to serve the whole workflow. A review has one job and can spend its attention on closed and low-probability cases that would never justify a person’s time individually.
Most proposals ask you to switch provider, migrate systems and retrain staff. This one asks for a copy of claims you have already submitted.
We do not bid for their scope, touch their workflow or report on their staff. Their contract and their fee are unchanged.
No new software to learn and no queue to adopt. We independently review the financial outcome after the normal billing process has done its job.
Our fee comes out of collections that arrive after — and because of — our work, measured against a baseline agreed in writing first.
Five recurring patterns. None of them imply anyone did anything wrong. Each follows from how normal billing operations are measured and prioritised.
Billed AED 4,800, reimbursed AED 4,100, marked complete. The AED 700 never becomes a task because the system has no reason to raise one.
Appeals are commonly worked in the order they arrived rather than by what they are worth. High-value recoverable claims can expire while low-yield items are cleared.
A 4.8% shortfall on one claim is hard to notice. The same shortfall across four hundred claims with one payer and one procedure family is a contract issue worth raising with that payer.
Every payer runs a submission window. Claims within a few weeks of that deadline have to be worked first, because after it they cannot be recovered at all.
One missing field or code pairing, recurring across a specialty. Recovering those claims returns cash, and identifying the pattern prevents the next ones.
Every figure traces to named claims, with the denial letter or remittance advice attached, so your provider can check any line.
That is the gap we review. Not by finding obvious billing errors, but by detecting patterns and economic priorities that only appear across the full claim population.
Software changes the economics of a second review. Every transaction can be screened, while people only investigate the small number that look financially meaningful.
Traditional billing systems tell you what happened to a claim. We build models around a different question: given everything we know about this claim, payer and history, what should happen next, and what is it worth pursuing?
| Payer | Procedure | Denial | Age | Amount | Prior result |
|---|---|---|---|---|---|
| Payer A | CPT 97110 | AUTH | 21d | 8,400 | Recovered |
| Payer A | CPT 97110 | AUTH | 38d | 6,750 | Recovered |
| Payer B | CPT 99214 | DOC | 16d | 2,900 | Written off |
| Payer A | CPT 97110 | AUTH | 19d | 9,100 | Recovered |
Modern tabular prediction methods are particularly useful here because clinic datasets are structured and often relatively small.
We benchmark methods including TabPFN, gradient-boosted trees and conventional statistical baselines against held-out outcomes. The operational model is selected on measured out-of-sample performance, not technology preference.
Early pilots may contain only a few thousand historical examples for a payer, specialty or denial family, and traditional modelling can become fragile at that scale. Accuracy, calibration, false positives and realised recovery are tracked separately by payer and workflow. If a model stops adding value, it stops being used.
There is no seat licence, no per-claim charge and no monthly retainer. You pay an onboarding fee and a share of what we recover.
| Component | When it is charged | Amount |
|---|---|---|
| Onboarding fee | Once, for data preparation and the leakage review | AED 10k–25k |
| Performance fee | Only on incremental collections attributable to our work | Agreed % of uplift |
| If we recover nothing | — | AED 0 |
A performance fee is only honest if both sides know what “extra” means. Before any work begins we fix the baseline in writing: historical collection rate, denial and recovery rates, payer and procedure mix, the measurement window, and which claims are excluded.
We then separate genuine recovery from ordinary growth, price effects, volume effects and mix effects, so the invoice is never an argument about attribution. Where a slice of eligible claims is deliberately left unworked as a control, that is agreed up front and used to evidence the difference our work made.
UAE law restricts the transfer, storage and processing of health data generated here to inside the country. We treat that as an architectural requirement rather than a policy paragraph.
Databases, processing and model inference all run in a UAE region on infrastructure we control, and backups stay in-country. The scoring models run on our own hardware, so claims data is never sent to a third-party AI service. Access is read-only wherever possible and named only, with a complete audit trail of every record opened and every decision taken.
We do not start by taking over your revenue cycle. We pick one payer, one specialty or one denial category, narrow enough to measure clearly within 90 days.
Read-only. No integration project.
See exactly what appears recoverable before deciding whether to continue.
Define what counts as incremental cash before we touch anything.
Your authorised team approves filings.
No performance recovery means no performance fee.
The proposition
We will tell you in three weeks, using your own numbers. If there is little to recover, you will know that, and you owe us nothing beyond the onboarding fee.