CO-97 Coverage Gaps Killed $532K – Our Week 1 Fix
Every clinic's nightmare: Patient walks in "covered." You deliver care. Payer denies CO-97 (non-covered service). $532K gone yearly from our 18-provider practice. 19% of ALL claims.
The brutal reality:
231 patients showed active coverage at registration
Post-service:Â UnitedHC, Aetna, Cigna all denied
Appeal success: Pathetic 37%
Billers wasted 41 hours/week chasing ghosts
RevsynAI changed everything Day 3: Live eligibility verification across 450+ payer plans flagged 231 coverage gaps at registration. Week 2: CO-97 denials crashed 87% (43→6 claims) Month 1: $489K collected vs written off
How they predict the unpredictable: ✅ Real-time plan details (deductibles, auths, exclusions) ✅ 97% coverage prediction accuracy ✅ Suggests payer-accepted alternate codes ✅ Auto-documents medical necessity pre-service
$5.8M annual billing math:
CO-97 risk: 19% × $5.8M = $1.1M potential loss RevsynAI: 2.3% risk = $133K loss YOUR WIN: $967K protected Year 1
Practice managers drowning in CO-97: Free CO-97 coverage audit reveals your exact exposure in 15 minutes. No more "patient said they were covered" excuses.
Staff finally sleeps. Patients don't get surprise bills. Revenue flows predictably.
