Be the billing company
NxtPivot is a full billing system built for billing companies. It finds money your practices already wrote off, turns their paper into claims, works every denial the day it lands, and runs the recurring money-finding jobs on a schedule.
Coverage sweep finished
200 patients checked · 3 came back covered
14 denials investigated
Root cause and next action ready on each claim
Underpayments flagged
41 visits paid under contract this month
All of it waiting before anyone signed in.
IllustrativeWhy billing companies switch
Four things you can tell your practices on Monday.
One
Stop the leakage.
Written-off denials, coverage nobody looked for, payers paying under contract, checks that never reconciled. Money that is already yours, leaving every month. We find it and get it back.
What it recovers →Two
Live in days, not a migration project.
Payer connectivity is an API call rather than a paperwork queue, and most payers come back within 24 to 48 hours. The paper backlog is a stack you photograph, not a week of typing.
How import works →Three
Every denial worked the day it lands.
Root cause, the rule it turns on, and a recommended action are waiting on the claim before a biller opens it. Your team reviews and decides instead of spending half an hour digging. Every denial, not the subset somebody had time for.
How the copilot works →Four
The price you agree to is the price you pay.
No annual escalator. No line items that appear after signature. Every AI action is metered and logged, so your invoice reconciles down to the individual claim. Ask your current vendor for that breakdown, then ask us.
Ask for a quote →What it does
The four things people actually buy it for.
It is a whole billing system, with all the parts you would expect. These are the four that change how the week feels.
Automations
Recurring money-finding work that runs itself.
Select rows on a list, pick what should happen, pick how often. Coverage sweeps, eligibility re-checks, statements, monthly reports. Priced, capped, and it pauses itself.
Read →Bill import
Photograph a superbill stack, get draft claims.
One sheet listing six patients becomes six review rows. Re-upload the same stack and nothing duplicates. Nothing is created until a person accepts it.
Read →Agents all the way
A copilot that works claims like a colleague.
On every screen, reading your real data. Explains any number in plain English, investigates a denial step by step, and asks before it contacts anyone.
Read →Recovered dollars
Underpayments, missed coverage, checks that come up short.
Compared against your real contracted rates, with recoupments linked to the claim they came from and anything unexplained flagged instead of buried.
Read →Why now
Your EHR keeps the charts. The billing work still lands on a person at 6pm.
Clinical systems are built to hold the record of care, and they are good at it. But the billing work around that record, the denials, the appeals, the eligibility hunts, the check that came in short, is still a human being with a spreadsheet at the end of a long day. NxtPivot is the layer that does that work, on top of whatever EHR you use.
That was a reasonable place for the industry to land. Investigating one claim properly costs twenty to thirty minutes of attention, and no amount of software design changes that arithmetic. What changed is that the investigating no longer has to be done by a person. That is the whole thesis, and it is why this is worth switching for now rather than in five years.
Read the full story →Keep your clinical record
Charting, notes and the clinical history stay exactly where your providers already work. We are not asking anyone to learn a new way to document a visit.
Keep your contracts
Credentialing and payer contracts carry over unchanged. What changes is the transaction-enrollment step, which is handled through an API rather than paperwork.
Move the billing work
Claims, remittances, denials, appeals, statements and the recovery work that never gets done: that is the part that moves, and the part that pays for the move.
The whole system
Everything a billing company needs, in one place.
The recovery work is the reason to switch. This is the rest of it, so you are not running two systems to get there.
Price lists that fill themselves in
A saved price per procedure per practice, plus each payer's contracted rate. Type a code and the charge prices itself. Load a schedule by hand, from a file, from another group, or by handing the assistant a spreadsheet.
A real patient account ledger
Every charge, payment, credit and write-off on one running account, with the guarantor named. When a patient disputes a bill, the whole story is on one screen.
Payment posting, both ways
Electronic remittances post and reconcile themselves. A paper check and an explanation of benefits get posted by hand, line by line, and the account cannot tell the difference afterward.
Statements that behave
Itemized, aged, printable. And it will not bill a patient while it is holding their credit, which is the kind of small honesty that saves a phone call.
Secondary insurance
After the primary pays, the secondary claim goes out carrying the primary's decision, and both payments net onto the same charges. Out-of-balance is blocked, not rounded away.
A worklist and the numbers
One claims list with filters, saved views, money per claim, and grouping by practice or physician. Plus the reports your practices ask for every month, exportable.
Want the exhaustive list? Ask on the walkthrough and we will go feature by feature.
The agents
Named, specialized, and easy to talk to.
NxtPivot is not one model with one prompt. Ask Pivot is the assistant your team talks to, and behind it sit specialists with one job each: reading documents, checking codes, scrubbing before submission, classifying denials, finding the governing rule, drafting the appeal, and checking the draft.
Meet the full cast →The math of revenue leakage
11.8%
of claims denied industry-wide
2024 industry average, up from 10.2%
60%
of denials are never appealed
The single biggest source of leakage
$25
to rework one denial by hand
MGMA average for a physician practice
64%
of denials are preventable (MGMA)
A pre-submission check would have caught them
Training
We train billers like a product company, not like a vendor.
Thirteen chapters, built into the product, that assume the viewer knows nothing. Chapter 0 teaches medical billing itself. Then every screen gets walked top to bottom before anything happens on it. A new hire can get productive without the owner sitting next to them.
See the full curriculum →- Ch 0 How medical billing works
- Ch 2 A new patient walks in
- Ch 5 From paper: one page or a whole stack
- Ch 7 The check is short
- Ch 8 "Why was this denied?"
- Ch 9 The monthly insurance sweep
Six of the lessons. There are more than forty.
Compliance
HIPAA-compliant, cloud-based, audited per claim.
Patient data stays inside the HIPAA-eligible boundary, every model call is covered by a signed business associate agreement, and every agent action is logged with what it read and what it cost. Your compliance officer reads the same trail your biller does.
Read the full posture →Free leak assessment
Sign a BAA. Send a report. Get a sized leak assessment.
Free of charge. No patient data moves until paperwork is signed. We return your denial gap, your coverage gap, and your A/R priority, sized in dollars for your own book.
Request the assessmentStraight answers
- Who is NxtPivot for?
- Billing companies and billing departments that run claims for multiple practices, and practices large enough to run their own billing. If your day is claims, remittances, denials and statements, this is built for you.
- Is it a full billing system or something that sits on top of one?
- A full system. Patients, charges, fee schedules, claim creation and submission, payment posting, remittance reconciliation, statements, denials, reporting and the automations around all of it. You do not need to keep a legacy system running underneath.
- How long until claims are going out?
- Payer connectivity for electronic claims and remittances is handled through an API rather than per-payer paperwork, and most payers come back within 24 to 48 hours. That is the transaction-enrollment step only: existing credentialing and payer contracts carry over unchanged.
- Can the AI do something we did not ask for?
- No. Reading is free and unrestricted. Anything that costs money or contacts a payer stops and asks, at a stated price. Sending a claim is always a person clicking send. Every run is logged with what it read and what it cost.
- What does it cost?
- Pricing is per provider group onboarded, quoted upfront after a scoping call, with no annual escalator. Every AI action is metered, so the invoice reconciles down to the claim.
From the blog
Playbooks for getting the leak under control.
Denial recovery
Why 60% of denials are never appealed (even though 70-80% of appeals win)
The math, the friction, and the playbook for closing the largest revenue gap in outpatient billing.
Read →Found Money
Post-approval Medicaid retro-eligibility: the cash cow billers still do by hand
How to automate the highest-leverage workflow in your operation.
Read →CARC playbook
CARC 197 decoded: how to win back missing-authorization denials
The most common denial code in outpatient billing, and the appeal template that wins.
Read →Run it on your own workflow
Bring one claim you argued about. We will work it in front of you.
Fifteen minutes, screen shared. No contract, no data required to start. You see what the system actually does, then you decide whether a pilot is worth a conversation.
Asks first
Nothing paid, nothing sent to a payer, without your confirmation.
24 to 48h
Typical payer connectivity turnaround, handled by API not paperwork.
Per claim
Every AI action metered and logged. Your invoice reconciles to the claim.
No escalator
The price you agree to is the price you pay. Quoted per provider group.