Payers deny. You appeal. We make sure you win more.
Overturn is the denial recovery engine for behavioral health. We ingest your remits, write chart-grounded appeals for every denial worth fighting, file them on time with your approval, and track each one until the money lands.
| Appeal | Payer | Level of care | At stake | Status |
|---|---|---|---|---|
| A-1042 | Anthem | PHP | $9,800 | Appeal filed |
| A-1046 | UnitedHealthcare | IOP | $6,300 | Deadline in 9 days |
| A-1038 | Cigna | Residential | $14,200 | Overturned, paid |
| A-1049 | Aetna | Detox | $5,100 | Drafting |
The problem.
Most denied behavioral-health claims are never appealed, and payers count on it
The appeals never get filed
Fewer than one in a hundred denied claims are ever appealed. The work is slow, the filing deadlines are tight, and your clinical team is already full.
Payers price that in
More than half of the denials that do get fought end up paid. When yours go unchallenged, denying costs the payer nothing, so the ones you skip are revenue you already earned and left behind.
Start with your 835s and EOBs
Send us your remits and denial letters. Overturn parses every CARC and RARC code and flags which denials are worth appealing and what each one is worth.
Appeal from the actual chart
We write each appeal from the record: ASAM level-of-care criteria and the payer's own medical-necessity policy, argued fact by fact. Nothing is filed until a human on your team approves it.
Filed, then tracked until it pays
We submit through the payer portal, follow every filed appeal, and escalate upheld denials to the next review level while the window is open, tying each recovery back to the remit.
Beyond the appeal.
The engine behind the appeals builds agents for the rest of your back office
Overturn is built out of agents: software that reads your systems, does the repetitive half of a workflow every day, and hands a person the judgment call. We build them for the rest of your revenue cycle too, one workflow at a time.
Built for behavioral health, not adapted to it
The workflow already knows ASAM criteria, PHP and IOP day counts, authorization windows, and what 42 CFR Part 2 does to an alert. Nothing has to be explained to it twice.
Connected to the systems you already run
Kipu, Alleva, Ritten, Sunwave, your clearinghouse, and the payer portals your billers log into every morning. Read access is enough to start.
A person approves anything that leaves the building
Agents read, draft, check, and queue. Nothing is submitted, posted, or sent until someone on your team approves it.
| Agent | Ran | Result | Waiting on you |
|---|---|---|---|
| Benefit check | 06:10 | 14 new inquiries verified against the plan. 2 came back out of network. | 2 waiting on your call |
| Authorization watcher | 06:20 | 3 authorizations end within 5 days. Concurrent review packets drafted from the chart. | 3 drafts for UR to approve |
| Remit posting | 07:05 | 212 paid lines posted. 9 paid under the expected rate, held out of the posted batch. | 9 short payments to review |
| Chart audit | 07:40 | 38 notes checked before billing. 4 are missing a signature and 1 has no level-of-care justification. | 5 charts back to clinicians |
Common questions.