82% of denied claims overturned on appeal
82% of denied claims that are formally appealed are eventually overturned, yet the vast majority of denials go unchallenged.AMA, 2024 — Prior Authorization Physician Survey
65% of denied claims never resubmitted
65% of denied claims are never appealed or resubmitted, representing billions in recoverable revenue abandoned annually.MGMA, 2025 — Revenue Cycle Benchmarking Report
85% higher BH denial rate vs. general medical
Behavioral health claims are denied at rates 85% higher than comparable general medical claims, driven by documentation complexity and medical necessity variability.KFF, 2024 — Mental Health Parity Analysis

Case law for claims.

Most vendors optimize throughput. We optimize precedent.

Precedent-based denial intelligence for behavioral health. We capture what actually wins — and make it permanent.

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What the payer knows
Payer
Evidence required
Threshold
United
PHQ-9 + GAD-7 scores
PHQ ≥ 15
Cigna
Functional impairment narrative
ADL regression
Aetna
Published literature + ASAM
Dim 5 ≥ 3
BCBS
Treatment plan + med compliance
14-day minimum
Humana
Peer-reviewed outcome data
p < 0.05
What the provider knows
CO-50: “medical necessity not met”
? which evidence failed
? what sequence they expected
? undocumented thresholds
— appeal template from 2019
— biller who knew retired

“The asymmetry isn’t clinical — it’s informational.”

Payers already reason from precedent — they just hope you don’t too.

See what your denials are hiding.

We start with your data and show you exactly where precedent intelligence recovers revenue.

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HIPAA MHMDA 42 CFR Part 2
Stratum Collective — p. 01