The Partner Program
The ClaimPilot partner program lets billing companies and RCM firms offer an orthopedic revenue recovery audit under their own brand. We run the audit engine underneath — line-by-line contract comparison, denial classification, coder-reviewed findings, drafted appeals — and you present the results as your service. Because it was your service that found the money.
Why This Exists
Your team is rightly focused on keeping current claims moving, so the old money slips: payers pay below contracted rates, and denied claims age past their appeal deadlines and get written off. It isn't anyone's failure — it's arithmetic. There aren't enough hours in the day to work every underpaid line twice. The recovery audit works that backlog for you, as a service your clients see as yours.
A recovery audit your ortho clients will immediately understand — offered under your brand, without hiring auditors, building tooling, or adding a workflow your team has to staff.
Recovered dollars are the most concrete value a billing partner can put in front of a practice. Every finding is verified against the client's own remittances, so the credit is real — and it's yours.
The engine is built around orthopedic denial patterns — global periods, modifier 25/59/X, laterality, implant and hardware reimbursement — by a practicing orthopedic trauma surgeon.
The Model
Two roles, kept cleanly separate. You own the client. We run the engine. Neither of us improvises the other's job.
By default, reports carry a discreet “Powered by ClaimPilot AI” attribution; fully invisible white-label is available by agreement. Either way, your brand leads — the client sees your name on the recovery.
The Path In
Each stage is earned by the one before it. No stage is sold before the previous one has produced a report.
Pick one ortho client. One month of remittances or one payer's denied and underpaid lines, run de-identified or under a signed BAA. You get a findings report under your brand within five business days of complete data. No fee, no obligation. Full sample details.
If the sample finds real money, run a 90-day pilot on that practice, with appeal drafts included. Client-facing terms: 20% of verified recovered revenue, $750/month floor, $10,000/month cap — “recovered” defined strictly off the practice's own 835s, with fees credited back if a payer recoups. Our bar: identify at least 10× the fee in credible recoverable revenue.
After a successful pilot, one standing agreement extends the audit across your enrolled orthopedic practices — same terms, same discipline, your brand on every report. Partner economics are set out in a written term sheet we'll walk through together on a call.
Compliance
The compliance chain is not a footnote; it is the first step of the engagement, and it is documented at every hop.
About the Engine
ClaimPilot AI was founded by Jacob Duncan, DO — Founder & CEO, and a board certified orthopedic trauma surgeon. Orthopedics has its own denial patterns — global periods, modifier misuse, implant and hardware reimbursement — and the audit logic is built around the codes and contracts ortho practices actually bill. That is why it catches what a general-purpose review leaves behind, and why your ortho clients are the right first audience. Meet the founder.
The next step is one client and one secure transfer.
Pick one ortho client and run the free sample audit. One report under your brand, one review call — and you'll know exactly how much recoverable revenue is sitting in that client's backlog, with your name on the finding.
Jacob Duncan, DO · Board Certified Orthopedic Trauma Surgeon · Founder & CEO, ClaimPilot AI · getclaimpilot.ai