Axis IRG Request a Billing Review

Methodology & Research

How we decide what
a claim is worth.

Our methods are written down, dated, and authored — the diagnostic framework, the scoring logic, and the payer intelligence behind every prioritization decision.

Methodology

Claim Value Scoring

By Christopher Ryan, Partner, Revenue Intelligence Systems · Reviewed by Peter Busch
Methodology v1.0 · Calibration reviewed as outcome data grows.

Every open claim gets a recoverability score from likelihood of payment, dollar value, payer behavior and effort to resolve. The score drives the Fix & Revenue Queue — the highest-value, most-winnable claims get worked first.

Scope & limitations. Applies to open behavioral-health claims under active follow-up. A high score prioritizes work on the available evidence — it does not predict or guarantee payment; a low score may reflect missing information rather than true nonrecoverability. Scores are estimates, not guarantees of payment, and depend on data quality and payer behavior.

Read the full methodology →
  1. 01

    Payment likelihood

    Denial reason, payer pattern, timing.

  2. 02

    Dollar value

    Expected collectible vs. contracted.

  3. 03

    Payer behavior

    Historical responsiveness & friction.

  4. 04

    Effort to resolve

    Steps, documentation, turnaround.

Diagnostic Framework

The 7-Point Diagnostic, in Brief

Seven checkpoints applied to every stuck claim — claim-build integrity is verified before a problem is assigned to the payer. This is the reference index; the full framework, with evidence requirements and outputs, is documented on its own page.

  1. 01

    Rejection Code

  2. 02

    ERA / Remittance

  3. 03

    Claim History

  4. 04

    Payer Relationship

  5. 05

    Provider Enrollment

  6. 06

    Code Integrity

  7. 07

    Claim Build

Built on infrastructure

A system behind every score, not a guess.

Payer intelligence, scoring logic, and a documented framework — the structure that turns scattered denials into prioritized, recoverable revenue.

Want the methodology applied to your claims?

Do not submit patient names, dates of birth, member IDs, diagnoses, clinical records, or other protected health information through the public website; secure information is requested only after the appropriate intake and contracting process.

Request a Billing Review →

Last updated: July 5, 2026