Identification and Recovery

Zero Risk. Maximum Reimbursements.

Wakefield is the leading provider of solutions that help providers maximize payor reimbursements, reduce patient billings, and eliminate the hassle of dealing with insurance companies. Insurance companies have rigged the system against providers to make it difficult to generate fair reimbursements, using a variety of questionable tactics to identify and limit payments on out-of-network bills to only a fraction of billed charges. With extensive knowledge of out-of-network payor strategies, Wakefield has developed a unique approach that works alongside your billing team to optimize out-of-network payments and re-pricing out-of-network bills.

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  • NO upfront costs NO minimums
  • NO cancellation fees
  • NO software required
    We are a success-based company. If you don’t get paid on your out-of-network claims, neither do we – which means we work even harder to identify and recover reimbursements on your out-of-network claims.

Upfront Recovery: Negotiations Service

When 3rd party vendors reach out to negotiate an upfront settlement, we step in using our proprietary data to maximize these reimbursements. Our typical providers have seen an average increase of 59% from initial offers! Some providers will see reimbursements as high as 90% of charges!

Post-Payment Recovery: Appeals Service

Wakefield utilizes technology & specialized expertise to comb through payor portals, EDI feeds, and EOBs to identify denials, underpayments, and 3rd party priced claims. We then use our proprietary data to challenge the pricing decision and recover you more money. On average we increase our clients’ initial payments by 87%!


To get our high yielding results, we rely on CRXIS, which stands for Wakefield Information Systems. This is the proprietary data and analytics tool we’ve developed to support us as we go toe-to-toe with payors. CRXIS is the largest health data network in the industry, and helps analyze insurance policies, provides comparable data, and allows us to track the tendencies and trends of the people on the side of the insurance companies and cost-containment vendors.


Our Expertise

We have over 20 years’ experience in the industry. We’ve built a unique team of experts who worked directly for the largest cost containment vendors and insurance companies, giving us the unique ability to understand their strategies and motives which allows us to stay ahead and get higher payments on bills for our customers. Our team offers advanced workflow processes to successfully navigate the complicated regulation surrounding the reimbursement processes.

We level the playing field, one claim at a time.

We offer a dedicated task force that can help you uncover thousands of dollars in new revenue by identifying underpayments & denials to be negotiated or appealed. No matter your claim type, Wakefield works across several payors to ensure that every claim is reviewed, denials and underpayments appealed, and the first & additional payments reconciled to ensure that you are getting all the payments you’re entitled to. With our no-risk approach, it’s a no brainer.


Find Out How Much Cash You Can Recover

Our Out-of-Network services can help uncover thousands of dollars from the payors. Click the button below to schedule a call with us for a free consultation, or to email us for more information!