Priced by the Work. Start With a Pilot.
No enterprise contract. No platform migration. Begin with a pilot, prove the results on your own claims, and scale — clinical rigor without the enterprise commitment.
Pilot
Send us a set of live claims. We review them to the same certified two-tier standard and deliver settlement-ready packages through your RMIS.
Prove It
Measure the results on your own book: reduction, defensibility, and adjuster time saved. The pilot is scoped so the comparison is yours to run, not ours to assert.
Scale
Roll out across volume on the same two-component basis: Tier I per billed line, Tier II per claim. No long-term lock-in, no minimums forcing the issue.
Priced by the Work — Not by the Savings
Two components, both tied to the size of the claim rather than the size of the result.
Tier I is priced per billed line across every bill on the claim. A claim carrying five bills and a hundred lines takes more auditing than one carrying a single bill, and the price says so directly. Tier II is a flat fee per claim.
Because the unit is a billed line, you can work out what a claim will cost before you send it — the demand package in front of you already contains the number. No estimate, no range, no surprise on the invoice.
What neither component is tied to is the outcome. The review costs the same whether it finds a substantial reduction or nothing at all. That distinction matters more than it sounds: when a reduction is challenged, the first question asked of any reviewer is what they stood to gain from the number they produced. Nothing is the answer that holds up — and it is the answer this model lets you give. A clinical finding is worth exactly as much as its independence.
- Tier I certified medical bill audit
- Tier II expert nurse clinical review
- Proprietary medical treatment calendar
- Line-by-line bill analysis with recommended adjustments
- Chronologically organized medical records
- Comprehensive nurse audit report
- Targeted negotiation strategy & key settlement points
- Complete time-stamped audit trail
Billed separately: one-time RMIS integration setup, and expedited handling when you need a package back faster than standard. Nothing else.
Built for Your Role in the Claim
Insurance Carriers
Reduce BI settlement severity with certified, consistent demand package review — without adding headcount or changing your claims platform.
TPAs
Add a certified medical review layer to your demand package workflow — and differentiate your TPA offering without building the capability in-house.
Self-Insureds
Challenge demand packages with the same clinical expertise large carriers use — without the enterprise budget or in-house clinical staff.
Before You Ask on the Call
Why is there no price on this page?
Because the cost depends on the size of the claim, and a single number here would be wrong for almost everyone. Tier I is priced per billed line, so a claim with five bills and a hundred lines costs more to audit than a claim with one bill. Tier II is a flat fee per claim. You get both figures before a pilot starts, not after.
What determines what a claim costs?
The number of billed lines in the demand package, and nothing else. Not the size of the settlement, not what the review finds, not how much it saves you. A claim does not cost more because the audit found more, and it does not cost less because it found nothing.
Is anything billed on top of the review fees?
Two things. RMIS integration setup is a one-time cost to connect DemandPro to your claims system, and expedited handling is priced separately when you need a package back faster than standard. Everything in the two-tier review and every deliverable listed above is covered by the review fees themselves.
Start a Pilot
Tell us about your claims volume and the bill types you see most. We'll scope a pilot that proves the value on your own claims — no commitment required.
- Walk through the full two-tier review process
- See a sample deliverable package
- Get your questions answered — no pressure
30 minutes · No commitment · Pick a time that works for you