Honest comparison
Keep denials in-house, or hand them off?
Most dental practices already work some denials with their own front office, and for some practices that is genuinely the right answer. This page lays out the actual math and the actual trade-offs, including the cases where you should not hire us.
The comparison, criterion by criterion
Neither column is free. In-house costs staff hours whether or not appeals win. Revamend costs a share of what is recovered. The question is which cost buys more recovered dollars for your practice.
| Criterion | Your front office works denials | Revamend works denials |
|---|---|---|
| Staff time per appeal | 30 to 60 minutes to pull the EOB, gather charting and radiographs, write the letter, and submit. Then one or two follow-up calls per claim, often on hold with the payer. | Zero staff hours. You upload remittance files once during onboarding; we triage, draft, and follow up from there. |
| Expertise per payer | Whatever your team has learned from the payers your practice sees most. Appeal rules, deadlines, and documentation requirements vary by plan, and they change. | This is the entire job. We work from per-payer playbooks for the roughly 30 denial codes that matter in dentistry, and appeals are AI-drafted then reviewed by a specialist before anything is sent. |
| Opportunity cost | Every hour on hold with a payer is an hour not spent answering phones, confirming appointments, filling the schedule, or collecting patient balances. | Your front office keeps doing front office work. Denial follow-up moves off their desk entirely. |
| Software and tracking | Usually PMS notes and a spreadsheet. Deadlines live in someone's memory, and when that person is out or leaves, the pipeline stalls. | A portal with per-claim status, deadlines, actions taken, and recovered dollars, backed by an audit log. Nothing depends on one person's memory. |
| Outcomes accountability | Almost never measured. Few practices know their appeal win rate or the cost per recovered dollar, so the work cannot be judged. | Accountability is structural: we are only paid a percentage of what is actually recovered, and every claim's outcome is visible in the portal. |
| What it costs | Wages for the hours worked, paid whether or not the appeal recovers anything. | 20% of recovered dollars, and nothing otherwise. Our first 5 founding practices pay 10%. No minimums, no setup fees. |
A worked example
Take a practice with 40 denied claims a month and a biller earning $28 an hour. These are ordinary numbers, not a worst case.
The in-house labor bill
| Denied claims per month | 40 |
| Time per appeal (writing and assembly) | 45 min |
| Appeal labor per month | 30 hours |
| Biller wage | $28/hour |
| Wage cost of appeals | $840/month |
| Follow-up calls and status checks | +8 to 12 hours |
| Realistic all-in labor cost | $1,100 to $1,200/month |
That is $840 in wages on letter-writing alone, and $1,100 or more once follow-up calls, payroll taxes, and benefits are counted. You pay it every month, whether the appeals win or lose. And it assumes your biller actually has 40 spare hours, which usually means other revenue work is not getting done.
The same month with Revamend
- Upfront cost: $0. No retainer, no minimum, no per-claim charge.
- If we recover nothing, you owe nothing, and you have lost zero staff hours finding that out.
- If we recover, say, $6,000 of those denials, our fee is $1,200 at the standard 20%, or $600 for the first 5 founding practices at 10%. The rest is yours.
- Your biller's 30 to 40 hours go back to scheduling, recall, and patient balances, work that also produces revenue.
To be fair to the in-house column: if your team recovers the same $6,000, their $1,100 of labor is cheaper than our standard fee. The catch is the "if". The fee only beats in-house when the in-house work actually happens, actually wins, and was not needed elsewhere. In most offices we talk to, denials are worked last, after everything else.
We are a new company, so we will not dress this up with invented client averages. The numbers above are arithmetic on stated assumptions; your denial mix determines what is actually recoverable. The free audit estimates that from your own file.
When in-house is the right call
An honest comparison has to include the cases where you should not hire us. Here are three.
Your denial volume is low
Under roughly 10 denials a month, the math changes. That is a few hours of work, the amounts at stake are smaller, and a contingency fee buys you less. Keep it in-house and spend the effort on prevention instead.
You have a dedicated biller with real capacity
If someone on your team already knows your payers, has hours free each week, and actually tracks appeal outcomes, in-house work can cost less per recovered dollar than any outside service. That setup is rarer than practices think, but when it exists, use it.
Your denials are mostly contractual write-offs
If your remittances are dominated by fee schedule adjustments (CO-45) and true plan exclusions, there is little to appeal for anyone, in-house or out. The fix there is fee schedule maintenance and treatment-plan verification, not appeal letters.
If any of those describe your practice, run the free audit anyway. It will tell you your denials are not worth outsourcing, which is a useful answer that costs nothing.
Find out what your denials are worth before deciding.
The free audit reads your remittance file in your browser and estimates the recoverable dollars. Nothing is uploaded and no account is needed. If the number justifies it, onboarding is fully online and takes about ten minutes.