For billing & RCM directors
Your team already knows how to work a denial. The better question is how many of them existed because nobody knew the expected rate at admission. PayerLenz gives billing payer-specific reimbursement benchmarks, eligibility built for BH plan design, and live AR reporting, so expected vs. actual stops being a month-end forensics exercise and becomes something you set up front.
Admissions makes the promise. Utilization review builds the plan. Then the remit hits your desk at 40% of what everyone assumed, and suddenly the variance is a billing problem. It was never a billing problem. It was an information problem, three departments upstream, months earlier.
Fixing that requires one thing: the same rate expectation, visible to admissions, UR, and billing, at the moment of the admit. That's what PayerLenz was built to put in place.
Every eligibility check returns the expected out-of-network reimbursement for that payer, state, and level of care, so front end and back end work from one number and “what did we think this would pay?” has an answer on file. Instead of an average, you get the full distribution: P25/P50/P75/P90 by payer group, state, level of care, and reimbursement methodology, with U&C, MNRP, MRC, and NAP claims tracked separately, because blending a Medicare-multiple plan with a usual-and-customary plan produces a rate that matches no real claim. BCBS is resolved to alpha prefix and home plan.
AR tracks against your own history: billed, allowed, and paid on open and closed claims, allowed and paid percentages by payer, and projected payment timing built from your actual remittance pattern, with trend views so a bad month reads as a bad month and not a crisis.
That matters most in payer conversations. When a payer quietly moves from the 80th percentile to the 40th, a trust-scored benchmark from a 260+ payer-group pool carries more weight than “we think you used to pay more,” and it's the difference between noticing in 30 days and noticing in two quarters.
There's also a discount attached to work your team already does. Your team touches claims data all day; contribute it de-identified and cut your plan fee up to 25% every cycle. The pool your own benchmarks come from gets deeper at the same time.
PayerLenz is the first product from Revenue Logic, a white-glove revenue cycle firm that works behavioral health claims every day. The people who designed the benchmark logic have personally worked the denials it's meant to prevent, and the methodology behind every figure is published, not buried. Read how the data works.
One rate expectation, visible to admissions, UR, and billing.