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Revenue Recovery and Denial Remediation – Systemic Remediation

Home Revenue Recovery and Denial Remediation – Systemic Remediation

The 35% Alpha: How Systemic Remediation Recovers $1B+ in Trapped Healthcare Capital

Key Factors:

For healthcare organizations, "trapped capital" in the form of denied claims, payer underpayments, and systemic RCM friction often accounts for 3% to 7% of net patient revenue.

For a $70B+ organization, that is a $2.1B to $4.9B opportunity sitting on the balance sheet, obscured by technical debt and legacy processes

Traditional Revenue Cycle Management (RCM) focuses on volume: processing more claims, faster. However, without addressing the root-cause data integrity issues, systems are simply "pouring more water into a leaky bucket."

Common leakage points include:

Data Integrity Gaps: Redundant systems (often a byproduct of M&A) that fail to communicate "Golden Source" patient data.

Regulatory Friction: Failure to align billing workflows with evolving federal mandates (MRA/MRIA standards).

Payer Sophistication: Payers utilizing AI-driven algorithms to trigger denials that legacy hospital systems are unequipped to appeal at scale.

Sanear Corporation operates on a Value-Creation Model

We ignore the incremental gains of standard collection agencies and focus on Systemic Remediation

1. AI-Driven Diagnostics: We deploy proprietary Python-based modeling to identify the "Golden 5" denial triggers—the 20% of systemic errors causing 80% of your capital loss.

2. The Alpha Recovery: We don’t just report on the problem; we execute the fix. By re-engineering the claims-to-payment pipeline, we have historically delivered a 32% increase in net payment recovery.

Standard consultants bill for hours and deliver slide decks. Sanear bills for Liquidity. By taking a 35% stake in the recovered capital, we absorb the operational risk. Our $200,000 monthly retainer covers the technology and the executive strike team; the performance fee represents our "skin in the game."

For example, when we recover $2.1B, the hospital realizes $1.37B in immediate, found EBITDA. Subsequently, we will continue our work to extract additional recovery, potentially yielding up to 7% or $4.9B that will be accretive to HCA's balance sheet.

The Bottom Line

In a low-margin environment, you cannot afford to leave $2.1B+ on the table. Systemic remediation is no longer an "IT Project"—it is a fiduciary obligation.

Sanear Corporation, is currently accepting a limited number of "Rescue" engagements for the 2026 fiscal year. If your system is facing a "leaky bucket," it’s time to seek the Alpha.

Is your organization leaving 5% to 7% of its revenue on the table? I look forward to your reply to discuss.

 

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  • Sanear Corporation
  • 301 E. John St, #973, Charlotte, NC
  • 704-882-4743
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