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Behavioral Health Denial Management

Get denied claimspaid.

We work the denials your team doesn't have time for.

Not ready for a call? Estimate your denials
  • No patient data needed to start
  • Official connections only
  • Commercial payers
  1. Denial received: 835 remit read from your clearinghouse
  2. Triaged: Sorted by cause, payer and deadline
  3. Evidence gathered: Chart pages matched to the denial reason
  4. Appeal drafted: Letter, timeline and exhibit index
  5. Specialist approved: Every statement checked against the chart
  6. Resubmitted: Sent through an official channel
  7. Paid: Outcome tracked to the remit

Works alongside the systems you already use

Works alongside systems like Kipu, Lightning Step, Sunwave, Alleva, CollaborateMD, Waystar, and the clearinghouse you already use.

01The problem

Most denials never get appealed.

Behavioral health denials often win on review. The work is what stops teams.

of residential denials overturned in California independent review.1
79%
of PHP and IOP denials overturned in the same reviews.1
87%
of denied claims are ever appealed.2
<1%
  1. 1.California DMHC, Independent Medical Review determinations, 2021 to 2026 (2026 partial), recomputed by Sky Gathering RCM. Member appeals that reached external review; an upper bound, not a forecast. View source (opens in a new tab)
  2. 2.Long, Lo and Pestaina, KFF, ACA Marketplace claims denials and appeals in 2024, March 2026. View source (opens in a new tab)

02How it works

Agents work. Specialists decide.

You get paid claims, not another tool to run.

  1. Step 01

    De-identified audit

    We size your denials by payer, reason and age. No patient data.

  2. Step 02

    Agreements first

    BAA, plus a 42 CFR Part 2 agreement for SUD, before any PHI.

  3. Step 03

    Agents triage and draft

    Sorted by cause and deadline, evidence pulled, appeals drafted.

  4. Step 04 · Human approval

    Specialist approves

    Every appeal is checked against the chart before it goes out.

  5. Step 05

    Resubmit and track

    Sent through official channels and tracked to payment.

  • Facility depth. Per diem, level of care, length of stay and carve-outs.
  • Your systems. We work across your EMR, billing system and clearinghouse.
  • Expert review. Every clinical statement cites the chart. Codes are never changed.
  • Official connections. Clearinghouse and payer APIs. No portal bots.
See how it works See a denial worked

03Services

Three ways in.

Most clients start with the audit.

What we commit to

  • Report in 10 business daysYour denial review report within 10 business days of receiving a de-identified export.
  • Specialist approvalEvery appeal is approved by a specialist before it is sent.
  • Logged and reportedEvery action is logged. You get a report every week.
  • BAA before PHINo patient data until a BAA is signed, plus a Part 2 agreement for SUD records.

Commitments about how we work, not promises about payer decisions.

Nasim Obeid, Founder of Sky Gathering RCM

04Founder

“Billing teams lose hours to checks a system should run.”

Founded by Nasim Obeid, former Director of AI and RPA development at a behavioral health provider, where he integrated Kipu, CollaborateMD and Stedi and built a revenue-cycle platform processing about $1M in claims a month, cutting manual processing by 70%.

Launching 2026 in Orange County, California.

Before Sky Gathering

in claims a month on the platform he built
~$1M
less manual claim processing
70%
less manual reporting
93%

Results from the founder's prior role, not Sky Gathering RCM client results.

View Nasim on LinkedIn (opens in a new tab)Read the founder story

Free resources

Work a denial yourself.

Next step

Book a denial review.

Twenty minutes. No patient data needed.

Or email hello@skygathering.com