Overturn is the denial recovery engine for behavioral health. We ingest your remits, write chart-grounded appeals for every denial worth fighting, file them on time with your approval, and track each one until the money lands.
PHP, IOP, residential, and detox. Commercial and out-of-network. Contingency pricing, zero risk to your facility.
| Claim | Payer | Level of care | At stake | Status |
|---|---|---|---|---|
| A-1042 | Anthem | PHP | $9,800 | Appeal filed |
| A-1046 | UnitedHealthcare | IOP | $6,300 | Deadline in 9 days |
| A-1038 | Cigna | Residential | $14,200 | Overturned, paid |
| A-1049 | Aetna | Detox | $5,100 | Drafting |
Medicare Advantage prior-authorization data, 2024. Source: KFF. Claim values are typical behavioral-health episode ranges, not a guarantee of results.
How it works
Four steps. You send the denials and the charts. We do the fighting, and nothing gets filed until a human on your side signs off.
Send us your remits and denial letters. Overturn parses every CARC and RARC code and flags which denials are worth appealing and what they are worth.
We write each appeal from the actual record: ASAM criteria and payer medical-necessity policy, argued fact by fact. No template with the names swapped.
Every letter is queued for a human on your team to approve before it goes out. We submit through the payer portal and log the confirmation.
The status watcher follows each filed appeal, escalates upheld denials to the next review level while the window is open, and ties every win to the remit.
The product
Medical necessity, timely filing, authorization, and coding denials each get their own playbook. Every filing window is tracked from the denial date forward.
Medical-necessity denials get argued clinical fact by clinical fact against the payer's own published policy and ASAM level-of-care criteria. Administrative denials get the strategy that actually moves them.
| Appeal | Window | Days left |
|---|---|---|
| A-1049 Aetna | 180-day internal | 164 |
| A-1046 United | 180-day internal | 9 |
| A-1051 Anthem | External review | 112 |
Nothing expires quietly. Escalations fire before windows close.
The status watcher checks every filed appeal and flags movement: pended, upheld, overturned, paid. Upheld appeals get escalated to the next level while the window is still open, so a first no is never the last word.
| Appeal | Last checked | State |
|---|---|---|
| A-1038 Cigna | Today | Overturned, paid |
| A-1042 Anthem | Today | Under review |
| A-1044 United | Yesterday | Upheld, escalating |
Every state change is logged and surfaced to your team.
Pricing
No setup fee, no monthly retainer, no per-appeal charge. If we do not overturn the denial, you do not pay. The economics only work for us when they work for you.
Our fee is a share of dollars actually recovered on overturned claims. Facilities keep 85 to 90 percent of every recovered dollar.
Compliance
We treat your patient data the way you are required to. Everything below is part of how Overturn operates, not an afterthought.
We sign a Business Associate Agreement before touching a single record, hold SUD records to 42 CFR Part 2, and structure our fee as a fair-market-value billing service rather than compensation tied to patient volume or referrals. This is a description of how we operate and is not legal advice.
"Most denied behavioral-health claims are never appealed. Payers know that, and it is priced into how they deny."Why Overturn existsAppeal everything worth appealing
A free denial review, no commitment. We will tell you what is winnable, what it is worth, and how fast we can start.