Hypex

We recover denied claims. You pay only when a payer pays you back.

Hypex works invisibly behind your existing billing operation: deterministic appeals citing each payer's own policy, follow-ups that run on a clock, and recovery verified on the payer's own remittance. No added headcount, no upfront fee, no seat licenses. You keep 85% of every dollar we bring back.

The audit takes ~2 minutes and needs no signup - results render instantly.

Claim fragment · CMS-1500

sample · not a real patient
PatientJordan A. Whitfield
DOB1972-04-18
MRNMRN-0042-8815
CPT99213
DenialPR-96 · non-covered
At issue$420.00

Awaiting payer

deterministic appeal filed

$357

yours (85%)

Identifiers are replaced with typed placeholders before anything leaves your network. The model sees the code and the dollar - never a name.

Remittance summaryverified terms

Contingency fee

of dollars the payer paid

15%

Patient data stored

identifiers removed first

0

Returned to your org

of every recovered dollar

85%

Appeals reviewed

by your team or on your terms

100%

The problem

Denials are rising. Most are never appealed.

Payers deny more claims every year, and denial work is pure labor: look up the rule, gather records, write the letter, chase the portal, follow up. Appeal volume scales with staff hours - so a large share of appealable denials is written off not because it lacks merit, but because nobody has a free Tuesday afternoon to fight it.

The industry's own numbers make the scale clear: initial denial rates sit in the low teens and climbing, roughly half of denied claims are never reworked, yet appeals that do get filed overturn at 40-80% depending on payer. The gap between "appealable" and "appealed" is where your revenue disappears.

Anatomy of an unworked denial

Denied by payer100%

11-13% initial denial rate industry-wide

Worth appealing62%

majority carry valid grounds

Actually appealed38%

staff capacity is the ceiling

Sources: Change Healthcare denial index; MGMA rework surveys; payer overturn data (36-85% by payer, Medicare Advantage 57-80%). Hypex exists to close that last gap.

What we built

A working system that protects patient data and recovers revenue

Built to keep patient data out and to recover money you would otherwise write off, with your team in control at every step.

Patient data never leaves your environment

Identifiers are removed before anything is processed. Anything we cannot fully de-identify is rejected rather than stored, so protected data stays with you.

zero-PHI

Appeals built to each payer's standard

Every appeal cites the specific denial reason and the payer rule it was judged against, in the format payer review teams expect.

payer-specific

Verified, not self-reported

Recovery is confirmed against the payer's own remittance before we bill. You only pay us on dollars you can verify in your own system.

835-verified

Your data, separated

Every organization's data is kept separate and access-controlled. Your workspace cannot read another's, and neither can ours read yours.

tenant-isolated

Product preview

Click through the actual platform

Each tab is a real screen from the running Hypex console with de-identified demo data - not mockups. This is the same interface your team would use on day one.

Denial intake & triage

live platform · de-identified demo data
Hypex console claims feed showing denial codes, payer, amount, and status chips

Every denied claim, de-identified. Batch-upload a CSV/835 or connect a clearinghouse feed; each claim is de-duplicated, scored for recoverability, and routed by payer rule. Identifiers were removed before anything reached this view.

CSV / 835 / SFTP ingestrecoverability scoringpayer-rule routing

Screenshots captured from the live production console. No PHI is shown anywhere.

How it works

From denial to recovered revenue

The workflow running in the live Hypex console today. Humans decide what ships; the system does the chasing, matching, and paperwork. Full detail lives on the How it works page.

  1. Connect your denial feed

    Share denials through your existing clearinghouse or a simple file upload - whatever your team already uses. Patient identifiers are removed immediately; only codes and amounts continue.

  2. We find the real reason

    Every denial is mapped to its true root cause - and whether it's worth appealing, what the filing deadline is, and exactly which evidence wins. Before any letter is written.

  3. We draft, you approve

    Appeals are written from your payer's own policy, with the cited rule shown beside each draft. Nothing submits without a person saying yes.

  4. Get paid, then we bill

    Approved appeals go out clean - checked for completeness, never filed twice. When money comes back, it's confirmed on the payer's own remittance, and our 15% applies only to what you actually received.

  5. Silence gets chased

    If a payer stays quiet, follow-up letters stage automatically on an escalating schedule for your reviewer to send. No appeal dies quietly in a queue.

  6. Every outcome makes us smarter

    You record won / partial / lost per appeal; those real results sharpen how the next denial is handled - for you and every client after you.

  7. Roll out once it works

    Start with one denial category and one payer, watch verified recoveries land, then expand at your pace. No upfront fee at any stage.

Estimate your recovery

How much denied revenue could come back to you?

Use your own numbers to see what recovering your appealable denials could return, after our 15% success fee. It runs in your browser, nothing is collected.

Quick start

Estimate your recovery

What could come back to you?

Match your own numbers. Runs entirely in your browser - nothing is sent anywhere.

$1,400
70%
60%

Industry overturn rates run 36-85% by payer; Medicare Advantage 57-80%.

Where the money sits

Denied write-offs
$420,000
Appealable portion
$294,000
Recovered at your win rate
$176,400

Net to you / month

$149,940

after the 15% fee on $176,400 recovered · you keep 85%

you · $149,940
15%

Recovered / year

$2,116,800

Hypex fee / year

$317,520

Staff hours this replaces

42 hrs/mo

About 1 full-time reviewer of appeal work - roughly $924/mo in loaded labor you don't have to hire.

Illustrative estimate only - actual results depend on payer mix, denial reasons, and documentation. Hypex is paid solely on dollars the payer actually pays, verified against the 835 remittance.

Architecture

Every claim on this page is enforced by code

Each capability below is something you get as a client - what it does for you, not how we built it.

Patient data can’t pile up

Identifiers are destroyed within minutes of use - automatically, with no manual step and no archive to breach.

zero-PHI

The real reason, every time

Each denial is mapped to its true root cause, whether it’s worth appealing, the filing deadline, and exactly what evidence wins - before any letter is written.

root cause

Accurate letters, no AI roulette

Standard denials get precise letters assembled from your payer’s own policy. Complex cases get AI help that cites its source - and anything uncertain goes to a human, never out the door half-sure.

accuracy first

Clean submissions, zero duplicates

Every resubmission is checked for completeness before it leaves, and the same appeal can never be filed twice - protecting your payer relationships and your compliance record.

clean claims

Billed only on money you keep

Your invoice comes from dollars the payer actually paid you - confirmed against their own remittance. Partial payments billed fairly; takebacks never billed at all.

fair billing

Silence gets answered

Payers that go quiet are chased automatically on a schedule until they respond - and every win, partial, or loss sharpens how we handle your next denial.

no black holes

A record you can hand an auditor

Every action on every claim is permanently recorded and tamper-evident. Export the complete history of anything, any time, for audits or client reviews.

audit-ready

We earn when you earn

One fee: 15% of recovered dollars. No seat licenses, no minimums, nothing upfront. If the payer doesn't pay you, you owe us nothing.

aligned incentives

Trust posture

every claim enforced in code

Credentials we hold, and one we're honest about

Trust postures are usually a wall of logos. Ours is a ledger: what is true today, with the mechanism behind it - and the one examination still open, stated plainly.

HIPAA Business Associate

in force

BAA covers all eight required elements of 45 CFR 164.504(e); signed before any PHI moves.

Zero-PHI, provably

in force

Patient identifiers are destroyed within minutes. Your security team can verify it against our live system themselves.

Encrypted end to end

in force

Your data is encrypted moving and at rest - the standard your IT team expects, verified not just promised.

Audit-ready history

in force

Every action permanently recorded, tamper-evident, and exportable on demand - ready for any auditor or client review.

Your data stays yours

in force

Each client's workspace is fully isolated from every other's. No exceptions, no shared views.

SOC 2 Type II

in progress

Examination in progress. Control matrix and audit timeline available on request.

We never claim a certification we do not hold. The full control matrix - every commitment mapped to its enforcement mechanism - lives on the Security page.

View control matrix

Security & compliance

What we do to protect PHI

Hypex operates as a business associate under HIPAA. Each control below carries an attestation stamp.

Zero-PHI test: request the verification package

A reproducible test asserts no patient identifier reaches the database, the model, or the letter store. Send a request and we email the runbook to your security team, so you can run it against our build before signing. Most vendors only assert this.

Request the suite →
Live

PHI never reaches the model

De-identified records only. The language model processes codes and tokens; patient data is not in its training, context, or storage path.

Live

Encryption in transit and at rest

TLS 1.2 or higher on every connection. Managed encryption for storage and the database, with keys held in the cloud provider's key management service.

Live

Access control and audit

Tenant-scoped data access, token or API-key authentication, IP-allowlisted machine ingest, least-privilege roles, and an append-only audit trail of every action.

Live

Verifiable, not asserted

An open test suite asserts that no patient identifier reaches the database, the model, or the letter store. Your security team can run it themselves.

FAQ

The objections, answered plainly

Fifteen questions billing companies, clinics, and hospital teams actually ask - grouped by audience: cost & model, data & security, small firms, compliance & liability.

cost & modeldata & securityfor small firmscompliance
Read the FAQ

Start your pilot

From signup to first recovery in four steps

  1. 1

    Create your workspace

    Five minutes. BAA ready the moment you sign - no waiting on us.

  2. 2

    Share one payer's denials

    A de-identified file - CSV or 835. Nothing raw leaves your side.

  3. 3

    Review real drafted appeals

    You approve what ships; follow-ups stage themselves.

  4. 4

    Get paid, then we invoice 15%

    Confirmed on the payer's own remittance. You keep 85%.

The deal

  • 15% only on verified recovery
  • Nothing upfront, no seat fees
  • Cancel anytime, no lock-in
Start your pilot Not ready? Run the free audit first.