Brightline Behavioral Health (Sample)

Recoverable: $17,698 – $30,971 (40%–70% of the pile)

Credentialing denials cluster and reverse in bulk: once the enrollment or roster linkage is corrected, payers commonly reprocess the whole affected span on a single project claim. The main risk is enrollment effective-dating.

Recoverable: $5,752 – $11,504 (25%–50% of the pile)

Many payers allow retro-authorization or reconsideration when the service was clinically justified and an auth existed for adjacent dates. Success depends on payer policy and how recently the denial posted.

Recoverable: $3,428 – $7,713 (20%–45% of the pile)

A large share of eligibility denials are retro-reinstated: Medicaid renewals often backdate, and misidentified-patient denials resubmit cleanly with corrected IDs. Claims older than the retro window are excluded from the high estimate.

Recoverable: $3,974 – $6,812 (35%–60% of the pile)

These are administrative, not clinical, denials: the money is usually payable once the requested document is actually supplied. Recovery falls off sharply past each payer's reopening window, which caps the range.

Recoverable: $499 – $1,498 (5%–15% of the pile)

Timely-filing denials are the hardest to reverse — most payers only pay on proof of original timely submission (clearinghouse acceptance reports) or documented good cause. We count only claims where such proof plausibly exists.

Recoverable: $1,248 – $2,288 (30%–55% of the pile)

COB denials mostly pay once the claim is routed to the correct primary or the primary's EOB is attached — but each one is manual work, and some primaries will themselves deny for timely filing.

Recoverable: $774 – $1,549 (25%–50% of the pile)

Corrected-claim resubmission fixes most of these where the underlying service was billable. Bundling and frequency edits are often correct as adjudicated, so we discount those heavily.

Recoverable: $0 – $154 (0%–5% of the pile)

True duplicates are not money — they were paid or denied on the original. A small residue are false duplicates (same-day distinct services missing a modifier), which is all the high estimate counts.

Recoverable: $88 – $352 (5%–20% of the pile)

Benefit exclusions rarely reverse. The recoverable slice is medical-necessity denials with strong clinical documentation, which win on appeal more often than offices expect — but we assume only the well-documented subset.