$43.84–$57.23
staff cost to fight one denial by hand
Premier, 2022 / 2024 surveys
The leak
The denials your clients write off are also your retention risk.
About 19% of in-network claims were denied on ACA marketplace plans in the most recent data1 — and nationally, roughly 65% of denied claims are never resubmitted.2 Not because they’d lose: because at hand-written effort, each one costs more to fight than anyone budgeted.
Every practice owner eventually runs this math on their own remittances. When they do, the question lands on you: what is my billing company doing about the denials? A worked backlog is a renewal argument. An unworked one is a competitor’s opening.
~35 worked ~65 never resubmitted2
The arithmetic
Why the small-dollar appeal never got written — until now.
Fighting one denial by hand costs $43.84–$57.23 of staff time.3 Under that cost, only the biggest claims justify an appeal — everything else is written off on sight. Change the unit cost and the same backlog changes character:
$9 to $5
a finished, citation-verified letter — volume credits
plus your biller’s review minutes
$48
your fee on one recovered $800 imaging claim at a typical 6% of collections
worked example — your rate may differ
The point isn’t one claim — it’s that appeals that were unprofitable at ~$50 of staff time
become profitable at $5–9. The 65% of denials nobody resubmits is where your unearned fees sit.
The desk
One account for the whole book. One line per client.
The Partner Account is built for the multi-client desk — the thing patient-side appeal tools and demo-gated enterprise platforms both skipped.
Credits held per practice
Buy per client, bill the right one every time. Balances never blur.
One team, every client
Your billers share one login; every appeal records who filed it, for which client.
Client-by-client visibility
Open any practice for its appeals, credits, and what’s still in review.
The same cited letters
Every claim in every letter links to a named, verbatim source. The provider signs.
No implementation project
No EHR integration, no IT ticket, no demo call. First letter in minutes.
The commission
Refer a practice once. Earn on everything it spends.
Some clients will want their own Merits account — solo physicians especially. Refer them with your partner link and the relationship keeps paying you, without adding a single task to your queue.
Tier one
Partner
20%
- What you earn
- 20% of what every client you refer spends
- How you qualify
- From the moment your account is approved
- How long it lasts
- Recurring on every purchase they make, for 12 months
Top tier
Preferred Partner
25%
Recurring — for the life of the client- What you earn
- 25% of everything your referred clients spend
- How you qualify
- Earned by active partners — promotion is automatic
The guardrail
The denials that shouldn’t be appealed cost you nothing.
Your recommendation is the asset. So when a denial rarely wins on the merits — a correct patient-responsibility determination, a sequestration reduction, a true duplicate — Merits says so before a credit is spent, and explains why in writing you can forward to the client.
Assessment — no chargePR‑1 · deductible
“Manufacturing a medical-necessity challenge would not be supportable. This balance is the patient’s deductible under the plan — we recommend billing the patient, not appealing.”
Real engine output on a correct patient-responsibility denial. The claim never cost a credit.
And when a letter is generated, it can’t leave without the provider: unsupported claims become review flags that block the download, the provider attests and signs under their own name, and the letter never mentions Merits or AI. We’re harder on our own letters than any payer will be.