Hypex
Contingency RCM — pay only when a denial is reversed

Turn denied claims into recovered revenue.

AI-drafted appeals. 15% contingency. Zero PHI leaves your network. You keep 85% of every dollar recovered.

15%

Fee — only on dollars the payer actually paid

0

Patient identifiers in our database

85%

Of every recovered dollar back to you

100%

Appeals human-reviewed or confidence-gated

See it in action — sample claimDemo · not a real patient

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

PHI is stripped before it leaves your network. The model sees the code and the dollar — not the name.

The problem

Denial rates doubled in a year. Most groups write off what they could recover.

In 2026, 20% of providers reported denial rates above 5% — up from 12% the year before. The appeals that win are sitting in a queue, waiting for staff time that doesn't exist. Most groups appeal a fraction of their denials and write the rest off.

Hypex processes the full denial population — every one, not a sample — and keeps your team in control of every submission. The recoverable revenue stops being left on the table.

How it works

From denial to recovered revenue, in three steps

  1. 01

    Connect your denial feed

    Upload 835 remittance files, push via API, or connect a clearinghouse. PHI stays in your network — we receive only de-identified codes and an opaque token.

  2. 02

    We draft the appeal, you review it

    Hypex classifies each denial, cites the payer rule, and writes the appeal letter. Safe appeals auto-submit; everything else routes to your reviewer. You authorize every submission.

  3. 03

    Payer pays → we reconcile → you keep 85%

    Approved appeals transmit as validated X12 837s to your clearinghouse. When the payer pays, we parse the 835, confirm the recovery, and invoice 15% of the amount received. Zero upfront, zero risk.

Trust & compliance

Built for the compliance team, proven in the sandbox

73% of appealed denials reversed

In sandbox testing, appeals drafted and submitted through the Hypex loop reversed within 21 days. Results are sandbox-only — real pilot data will be published.

92 payer rules seeded across 10 payers

UHC, Aetna, Cigna, Humana, Anthem, BCBS, Kaiser, Molina, Medicare, Medicaid. Each appeal cites the specific rule the payer uses.

Open PHI-leak test suite

Your security team can run it against our build before signing. Most vendors only assert compliance — we prove it.

Open PHI-leak test suite — run it yourself

An open test asserts no patient identifier reaches the database, the model, or the letter store. Your security team can run it against our build before signing. Most vendors only assert this.

View the suite →
Live

PHI never reaches the AI

De-identified records only. The model processes codes and tokens; patient data is not in its training, context, or storage. Verifiable by our open test suite.

Live

Encrypted in transit and at rest

TLS 1.2+ on every connection. Managed encryption for storage and database, keys held in the cloud provider's KMS.

Live

Tenant-isolated data

Every organization's data is scoped and access-controlled. Your workspace cannot read another's. Audit trail on every action.

Live

Verifiable, not asserted

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

Hypex operates as a business associate under HIPAA. SOC 2 Type II examination in progress — control matrix available on request. We never claim a certification we do not hold.

FAQ

Questions buyers ask

Do you ever see patient data?

No. Claims are de-identified before they leave your network. Our database and model handle only codes and an opaque token — verifiable by our open PHI-leak test suite.

What do we pay?

A flat 15% of the amounts the payer actually pays on appeals we file. No upfront fee. No retainer. If an appeal recovers nothing, that claim costs you $0.

Who decides what gets submitted?

Your team. Auto-submit applies only to high-confidence, low-dollar appeals; the rest route to your reviewer with the cited rule shown. Nothing is sent blind.

How long until go-live?

A sandbox pilot on sample denials runs in one to two weeks. Full automated submission depends on payer EDI enrollment, typically six to ten weeks, run in parallel.

How do I know PHI never reaches the model?

We publish an open test suite that asserts no patient identifier reaches the database, the model, or the letter store. Your security team can run it against our build before signing. Most vendors only assert this — we prove it.

Start a pilot

Recover your first denied claim — risk-free

No call, no commitment. Tell us where to send the workspace and we'll have you running in one to two weeks.

Send the workspace to

Why teams say yes

  • Zero-PHI by architecture — verifiable, not promised
  • Flat 15% only on dollars the payer actually paid
  • Every appeal human-reviewed or confidence-gated
  • No upfront fee, no added headcount, no sales calls
How we protect PHI →