Recover Written-Off Medicare Advantage & Commercial Inpatient Revenue. Zero Payroll Overhead.
Signal Core Solutions delivers done-for-you, criteria-backed clinical appeals for Michigan Critical Access Hospitals. We overturn complex short-stay downgrades and clinical validation denials—with zero upfront cost and no EHR integration required.
- 100% Risk-Free
- Paid only on collected cash
- Standard BAA
- Secure intake via encrypted SFTP/PDF
- RN-Engineered
- Every rebuttal verified by a licensed Michigan RN
Why denials go unworked
Rural hospitals don't lose these appeals. They never get filed.
The PTO & Bandwidth Trap
Floor UR teams are consumed by daily census and discharge placement. Complex 10-page commercial appeals expire in aging A/R before anyone can work them.
Improper MA Downgrades
Payers bypass the Two-Midnight Rule using proprietary commercial algorithms, downgrading medically necessary inpatient stays to observation.
High Consultant Overhead
Traditional RCM consultancies demand massive minimum retainers that small rural facilities can't justify.
The Regulatory Defense Engine
Three pillars built into every appeal packet.
CMS-4201-F
For Medicare Advantage denials: binding MA plans to CMS Two-Midnight standards and invalidating proprietary level-of-care criteria.
Objective Severity of Illness & Intensity of Service
Deep extraction of bedside nursing notes, vitals, IV titrations, and telemetry to rebut MCG/InterQual observation arguments.
Clinical Validation Defense
Defending Sepsis-2 vs. Sepsis-3, acute respiratory failure, and encephalopathy against retrospective downcoding.
Commercial plans aren’t bound by CMS-4201-F. For commercial denials, each appeal is built on the plan’s own contract language, its published medical-necessity criteria, and the objective clinical record.
Target high-yield conditions
Where short-stay downgrades concentrate.
Chest Pain / Syncope
1–2 midnight short stays
CHF & COPD Exacerbations
Severity escalation documentation
Sepsis & Severe Sepsis
Bedside organ dysfunction defense
Cellulitis / TIA / Syncope
Failed outpatient treatment documentation
How the pilot works
Three steps. No IT tickets.
- STEP 01
Execute BAA & Send 5 Charts
No EHR integration or IT tickets. Securely transfer 5 closed commercial/MA denials from the last 90 days via encrypted PDF/SFTP.
- STEP 02
We Build & Sign the Rebuttals
Our internal engine synthesizes the chart against payer criteria; a licensed RN reviews, signs, and formats the appeal packet for submission.
- STEP 03
Collect Cash, Split the Win
Your team submits the packet. When the payer remits payment, we invoice an 18% contingency fee. If the claim is not overturned, you owe $0.
The Contingency Model
18% of cash collected. Nothing else.
- $0 upfront. No retainer, no minimums, no setup fee.
- Paid on remittance. We invoice only after the payer remits payment.
- $0 if not overturned. No overturn, no fee.
The contingency agreement is reviewed with you alongside the BAA, before any charts are exchanged.
Start the pilot