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Appeal Generator
4 input methods. Payer-specific letters, credential-stamped on approval.
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Open →Claim Triage
Score every claim 1–10. Filter, prioritize, send to appeal or audit.
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Open →Coding Audit
CPT / ICD-10 audit against payer LCDs. Structured ERROR / WARNING / PASS findings.
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Open →Prior Auth
PA request letters, retro-auth appeals, PA tracker with status management.
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Open →Module 1 · AI-Powered
Denial Appeal Generator
High-priority claims (7–10). Click to auto-fill the form.
Drop EOB, ERA, or denial PDF — or click to browse
.835 · .txt · .csv · .xlsx · .pdfModule 2 · AI-Powered
Claim Triage Engine
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High Priority 7–10
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Deadline <30 Days
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Total Billed
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Module 3 · AI-Powered
Coding Audit Module
Upload CMS-1500, UB-04, or clinical documentation
.pdf · .xlsx · .csv · .txtSelect a claim to audit its coding.
Module 4 · AI-Powered
Prior Auth Assistant
Active PA requests
Module 5 · AI-Powered
RC Analytics & Compliance
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Revenue At Risk
Denial Volume by Payer
Denial Code Distribution
Claim Score Distribution — Triage Health
Practice Management
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Self-Service (12%)
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Complete this form to request access to the Fuuta Revenue Integrity LLC RecoverIQ Self-Service platform (12% contingency). Ibrahima Wagne will review and activate your account within 1 business day.
Organization Information
Primary Contact / Administrator
EHR & Technology
Payer Mix (approximate %)
Denial & Revenue Issues
Service Selection
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Fuuta Revenue Integrity LLC
About Ibrahima Wagne
RN · Active 2010MSNMBA 4.0 GPA
TableauLean Six Sigma
San Francisco, CA
Who You're Working With
Ibrahima Wagne
RN, MSN, MBA · Founder, Fuuta Revenue Integrity LLC
I'm a registered nurse and revenue cycle consultant. My background sits at the intersection of clinical practice and healthcare finance — I understand what documentation actually says and what payers contractually require, which means I can find and fight denials that most billing teams miss.
Before starting Fuuta Revenue Integrity LLC, I spent over a decade leading revenue integrity programs at major California health systems — auditing charge capture, rebuilding denial workflows, and deploying the technology that makes all of it work at scale.
When you work with Fuuta Revenue Integrity LLC, you're working directly with me — not a team of offshore billers, not a junior analyst. Every appeal letter, every audit finding, every report carries my name and my license.
Which service are you here for?
Hospitals & Health Systems
Contingency-based denial recovery and the RecoverIQ AI platform for high-volume claims environments. 12% self-service or 16% fully managed.
Private Practices — FRIO Program
Fractional Revenue Integrity Officer for practices losing 5–10% of revenue to charge capture gaps, CDM mismatches, and first-pass failures.
Analytics & Reporting
Reports
Fuuta Revenue Integrity LLC
RecoverIQ Performance Report · Generated
Ibrahima Wagne, RN, MSN, MBA · Principal Consultant
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Portfolio Overview
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Revenue at Risk by Client ($K)
Portfolio Executive Summary
Ibrahima's cross-client performance overview
AI-Powered · Solo Founder Leverage
Document Center
Select Document Type
Appeals
Denial Appeal
Payer denial reversal — CO-50, CO-4, CO-197 and all codes
Retro-Auth Appeal
Retroactive authorization when prior auth wasn't obtained
Prior Auth Support
Clinical justification letter for PA submission
Second-Level Appeal
Escalation after first-level denial upheld
External Review Request
IRO/Independent review organization request
Medicare Redetermination
CMS Level 1 appeal for Medicare denials
Compliance Documents
Compliance Policy
HIPAA, billing, and coding compliance policies
Corrective Action Plan
Formal CAP with timeline, responsibilities, and metrics
Audit Report
Formal revenue integrity audit report for leadership
OIG Compliance Plan
7-element OIG compliance program documentation
HIPAA BAA
Business Associate Agreement for new client engagements
Engagement Letter
Consulting engagement scope, terms, and contingency rate
Regulatory Submissions
RAC/MAC Response
Response to Recovery Audit Contractor or MAC demand letter
ALJ Appeal Request
Administrative Law Judge appeal — Level 3 Medicare
OIG Self-Disclosure
Voluntary self-disclosure protocol submission
Refinement Mode
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Total Docs
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Approved
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Appeals
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Compliance
⚡ Batch Appeal Generator — Solo Founder Leverage
Select claims from the queue below. AI generates all appeal letters at once and saves them to your library. One review, one stamp, done.
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Generated This Session
| Claim ID | Payer | Denial Code | CPT | Billed | Score | Status |
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Business Development · Fuuta Revenue Integrity LLC
Ideal Client Profile
The Client Worth Pursuing
A physician practice or specialty clinic with 3–15 providers, $2M–$15M in annual billing, and $200K+ in recoverable denials per year — where the billing team is overwhelmed, the EHR is complex, and no one has the clinical + finance background to fight payers effectively. That gap is Fuuta's opening.
Target Specialties
Orthopedics & Sports Medicine
High CPT value, frequent PA denials, complex modifiersBehavioral Health / Psychiatry
LCD issues, CO-197 patterns, Medi-Cal complexitySurgery Centers (ASC)
High per-claim value, bundling edits, anesthesia billingMulti-Specialty Groups
Coordination complexity, multiple payer contractsPhysical Therapy / Rehab
Units billing, plan limits, prior auth renewalsPractice Profile
3–15 Providers
Large enough to have real denial volume; small enough that one consultant moves the needle$2M–$15M Annual Billing
Sweet spot for 12–16% contingency to be meaningful ($240K–$2.4M potential)$200K+ Annual Denials
Minimum denial volume for viable engagement economicsIn-house or small billing team
Not a large outsourced RCM company — they won't pay 16% on topEpic, Cerner, or Athena EHR
Systems you know; strong documentation infrastructureTrigger Events (Buy Signals)
New payer contract signed
New contracts mean new LCD rules and often an initial wave of denialsBilling staff turnover
Knowledge gap creates denial backlog immediatelyEHR migration or upgrade
Charge router changes cause undercoding and charge lag spikesRAC/MAC demand letter
Compliance urgency creates immediate consulting needPractice acquisition or merger
RCM systems don't integrate cleanly; denial spikes follow every mergerDecision Maker
Practice Manager / Administrator
Primary day-to-day contact; feels the denial pain directlyPhysician Owner / Medical Director
Signs off on consulting spend; motivated by revenue impactCFO / Controller (groups only)
Needs ROI framing — show the dollar math before the meeting⚠ Not a fit: Hospital system CFO — sales cycle 6–18 months, procurement required, not viable solo
Ideal Payer Mix
Medicare ≥ 30%
Federal rules, clear LCD/NCD framework — strong appeal groundsCommercial ≥ 35%
High per-claim value; contract language creates leverageMedi-Cal ≤ 30%
Necessary for CA market but low reimbursement limits recovery economicsSelf-pay ≤ 10%
High self-pay = collection problem, not a denial problemGeography & Access
California — Tier 1
On-site available, Medi-Cal expertise, existing networkMulti-state — Remote
Any state for remote engagements; no on-site limitationTime zone overlap
Prefer PT/MT/CT for real-time collaboration; ET workableTarget for first 3 clients: Bay Area / California — leverage existing network and on-site availability
The Revenue Math — Why These Parameters Matter
$32K–$240K
Annual revenue per managed client at 16%, assuming 10–30% denial rate and 50–70% recovery rate on $2M–$5M billing
3–5 clients
Maximum solo capacity at quality. Beyond 5 without systems = service quality drops and your reputation suffers
$200K floor
Minimum annual denial volume to make a 16% engagement economically meaningful for both parties — below this, fixed fee is better
Enter any prospect's details below. AI scores their fit against your ICP on 6 dimensions and gives a go/no-go recommendation.
These are walk-away signals. A client who hits any of these criteria will cost you more in time and credibility than they'll ever pay you. Disqualifying early is not losing business — it's protecting your capacity for the right clients.
Hospital system or health system billing departmentSales cycle is 6–18 months minimum. Requires RFP, procurement committee, legal review, and vendor credentialing. One "yes" person cannot move the deal. Not viable as a solo founder.
Annual billing below $1M or denials below $100KAt 16%, you'd earn $16K maximum if you recover everything perfectly. That's not a business relationship — it's a favor. Refer these practices to the self-service tools or a fixed-fee audit.
Already under contract with a large RCM companyThey're paying 4–8% to an outsourced billing company. Adding 16% on top is not a conversation they'll have. Exception: their current RCM company is performing poorly and they're actively considering a switch.
Practice is financially distressed or in collections processThey need a turnaround consultant or bankruptcy attorney, not revenue cycle optimization. Your contingency fees will never be paid — or will be paid last after everyone else.
Decision maker is not in the roomIf the person you're talking to cannot sign an engagement letter without 3 levels of approval, the sales cycle will kill you. Require access to the decision maker within the first two calls — or walk.
They want results in 30 daysDenial appeals take 60–180 days to resolve. A client with unrealistic timeline expectations will become an unhappy client — and in a referral-driven business, one unhappy client costs you three future ones.
Won't sign a BAA before sharing dataThis is a non-negotiable. Any client who resists a BAA either doesn't understand HIPAA (a red flag for their compliance posture) or doesn't take your business seriously. Both are disqualifiers.
Self-pay over 25% of payer mixSelf-pay denials are a collections problem, not a revenue cycle problem. You can't appeal an uninsured patient's inability to pay. High self-pay means the practice's financial issues are structural, not recoverable through denial management.
These questions do two things at once: they qualify the prospect against your ICP, and they position you as an expert before you've said a single word about your services. Ask them in order. Listen for the signals.
1
"What's your current first-pass denial rate, and how has it trended over the last 6 months?"
Most practice managers don't know this number precisely — which tells you the denial management is reactive, not systematic. That's your opening. If they do know it, you're talking to someone serious about revenue cycle.
✓ Good signal: "We're running around 18% and it's been climbing" — active pain, ready to act
⚠ Warning: "We don't really track that" — may not be ready for a systematic engagement
2
"When a claim denies, who owns the appeal — and what does that process look like today?"
This reveals whether appeals are being worked at all, who's doing it, and how much capacity they have. A billing person handling appeals on top of claims submission is stretched — that's your value proposition.
✓ Good signal: "Our biller tries but we don't have time to do it consistently" — clear gap
⚠ Warning: "We have a dedicated appeals team of 5" — may not need you
3
"What are your top 3 denial codes right now — do you know which payers are generating them?"
This question demonstrates your clinical expertise immediately. When you respond to their answer with "CO-197 with Anthem usually means your PA process has a gap at the pre-cert step — has your workflow changed recently?" you've already proven your value before the pitch starts.
✓ Good signal: They name CO-50, CO-197, CO-4 — systemic issues you can fix
⚠ Warning: They don't know their top codes — reactive practice may not be ready to invest
4
"Have you ever had a RAC, MAC, or pre-payment review audit? How did you handle it?"
Past regulatory exposure dramatically increases willingness to invest in compliance and prevention. A practice that's been through a RAC audit is a very different buyer than one that hasn't — they know what's at stake.
✓ Good signal: "Yes, last year — it was stressful and expensive" — compliance urgency is real
⚠ Neutral: "Never heard of it" — education needed before they'll value your compliance services
5
"If you could recover 60% of your denied claims over the next 12 months, what would that mean for the practice?"
This question makes the prospect do the math for you. When they say "that would be about $200K" — your 16% fee ($32K) becomes obvious value, not an objection. It also reveals emotional stakes: are they motivated by growth, survival, or just staying compliant?
✓ Good signal: They calculate quickly and their eyes light up — financial motivation is real
⚠ Warning: "We don't really know what we're losing" — unquantified pain is harder to close
6
"Who else would need to be involved in a decision to bring on an outside revenue integrity consultant?"
This surfaces the real decision maker without asking directly. It also tells you if you're in a 1-step or 3-step sales process. If they say "just me" — you can close on this call. If they name 3 committees — recalibrate your timeline and effort.
✓ Good signal: "Just me and the physician owner — can we do a quick call with both?" — close in 2 meetings
⚠ Warning: "We'd need to go through our board and legal team" — enterprise sales cycle, likely not worth pursuing solo
7
"What's happened with your revenue cycle in the last 12 months — any staff changes, EHR updates, or new payer contracts?"
Trigger events create buying urgency. Staff turnover, EHR migrations, and new contracts all spike denial rates within 90 days. If they've had any of these recently, the pain is fresh and they're already looking for help — whether they know it or not.
✓ Good signal: "We switched to Epic 8 months ago and denials went up 40%" — direct causation, clear need
⚠ Neutral: "Nothing major" — may need to create urgency through the audit offer
Closing the Discovery Call
If the prospect clears your ICP criteria and shows real pain in questions 1–3, close with: "Based on what you've told me, I think there's a real opportunity here. My next step is usually a free 30-minute Revenue Audit call where I pull 20–30 of your denied claims and show you exactly what we'd recover and how. Would that be useful?" — This converts a conversation into a demonstration of value, not a sales pitch.