Astonish
Get a free audit
Backed byYCombinator

Built for behavioral & mental health practices

Better care deserves
better cash flow.

You focus on better care. We find and recover the revenue hidden in denied claims — with a free audit and pricing tied to what we win back.

Get your free denial auditHow it works →

No upfront cost · Results-only pricing · 90-day guarantee

Recovery assessment

Behavioural health center

Recoverable revenue

$138,000

of $214,000 written off in the last 12 months

Medical necessity

Missing documentation

Coding errors

Not worth chasing

Delivered in 48 hours · No contract required

Voices from billing teams

“One time I call, they say the provider is not in network. The second time, they say in network. The information doesn't match every time.”
Billing managerPhysician-owned practice
Payer info
“Every January, the insurance companies took out the old plans and brought the new plans. That caused a lot of issues.”
Billing managerSpecialty practice
Plan changes
“I feel horrible if it's my fault that she's missing out on money. I don't know a way to fix this.”
Billing managerSmall practice
Revenue
How it works

From denied
to paid.

Find

We review your claims and identify the denials worth pursuing — by payer, reason, and dollar value.

Appeal

We gather the evidence, build payer-specific appeals, and follow each one through to resolution.

Recover

You review the work, track the wins, and decide when proven cases can run automatically.

Get a free audit

The problem

Care is your job.
Getting paid shouldn’t
be a second one.

Vague denial codes. Conflicting answers. Plans that change without warning. Revenue slips away while your billing team runs out of hours.

Give your billing team the evidence and follow-through to move claims forward.

40%

of denied claims go uncontested as teams run out of time.

$300K

in recoverable revenue written off per practice, every year.

60%

of billable staff time spent on manual denial work.

90+days

average denial age — cash that should already be in the bank.

Our approach

Proof first.
Payment when we deliver.

Start with a clear view of what you could recover. Move forward when the numbers make sense. Give us more autonomy only when we have earned it.

01

A free audit. A real number.

We review 12 months of claims and quantify the recoverable revenue in 48 hours. No contract. No cost.

02

Your results. Our incentive.

You pay a share of what we recover. No upfront fees, no platform charge, and no win for us without a win for you.

03

Your specialty. Our focus.

Purpose-built for therapy, psychiatry, and counseling groups — and the coding-heavy denials they face.

04

Your claims. Your control.

Review every appeal. See the outcomes. Decide when proven categories can run with less oversight.

Inside Astonish

You see the work.
You see the wins.

From the first audit to the final payment, every claim has a clear next step. Start with human review. Automate proven cases when you are ready.

01

The audit

Find your opportunity.

Get a dollar-quantified audit, with denials sorted by payer, reason, and recovery potential.

Astonish

Recovery audit

Recovery opportunity

$138,000

Written off

$214,000
#44192Medical necessityReady for review—
#44175DocumentationEvidence needed—
#44168CodingReady for review—

By payer · Reason · Recovery potential

Your recovery opportunity, quantified.

A free audit, delivered in 48 hours.

Interactive demo

Claim #44192

Medical necessity · Appeal review

✓ Clinical notes matched to the claim

✓ Payer criteria checked

✓ Appeal letter ready for your review

An example of the review process. No real claim will be submitted.

02

The appeal

Build the right appeal.

We gather evidence, apply payer-specific playbooks, submit, and follow through. You review the work before it moves forward.

Astonish

Appeal review

Claim #44192

Medical necessity · Appeal draft

Clinical notesMatched
Payer criteriaChecked
Appeal letterReady for review
Every appeal stays reviewable.

Your team keeps the final say.

Interactive demo

Claim #44192

Medical necessity · Appeal review

✓ Clinical notes matched to the claim

✓ Payer criteria checked

✓ Appeal letter ready for your review

An example of the review process. No real claim will be submitted.

03

The recovery

See the work. See the wins.

Follow every claim from submission to resolution. See what is in progress, what has been overturned, and what you have recovered.

Astonish

Recovery activity

Recovered

$2,220

Claims overturned

2

Recent recoveries

#44168Coding●  Overturned$1,240
#44150Medical necessity●  Overturned$980

Every action logged. Every appeal reviewable.

Every action. Every outcome.

A clear audit trail for every claim.

Interactive demo

Claim #44192

Medical necessity · Appeal review

✓ Clinical notes matched to the claim

✓ Payer criteria checked

✓ Appeal letter ready for your review

An example of the review process. No real claim will be submitted.

04

Your control

Earn the right to automate.

Your live win record makes the case. Start with human review, then choose which proven categories can run automatically.

Astonish

Automation

Medical necessity

Proven outcomes. Your decision.

Won in this category

47 / 52

Overturn rate

90%

Choose which categories can run automatically.

Automation happens on your terms.

Choose what runs. Review what matters.

Interactive demo

Claim #44192

Medical necessity · Appeal review

✓ Clinical notes matched to the claim

✓ Payer criteria checked

✓ Appeal letter ready for your review

An example of the review process. No real claim will be submitted.

Astonish

Recovery audit

Recovery opportunity

$138,000

Written off

$214,000
#44192Medical necessityReady for review—
#44175DocumentationEvidence needed—
#44168CodingReady for review—

By payer · Reason · Recovery potential

Your recovery opportunity, quantified.

A free audit, delivered in 48 hours.

Interactive demo

Claim #44192

Medical necessity · Appeal review

✓ Clinical notes matched to the claim

✓ Payer criteria checked

✓ Appeal letter ready for your review

An example of the review process. No real claim will be submitted.

Recover today. Improve tomorrow.

Every recovered claim
is a lesson for the next.

Every appeal sharpens our understanding of payer behavior. As the evidence grows, we catch missing documentation, coding gaps, and authorization issues before claims go out.

  • ↗  Payer-specific playbooks that improve with each result
  • ↗  Earlier flags for missing codes and documentation
  • ↗  Fewer preventable denials reaching the queue

Claim readiness

Catch the gap.
Keep the revenue moving.

Prior authorization

90837 authorization added

Diagnosis pointer

Mismatch corrected

Modifier & units

Verified and ready

Denial riskHigh Low

Your practice. Our priority.

Built around
your practice.

Therapy, psychiatry, and counseling groups deserve more than a hospital-sized tool with an enterprise-sized contract.

Specialty
Behavioral & mental health
Team size
5–25 providers
Playbooks
Specific to your specialty and payers
Control
Human review, with autonomy you choose

Simple, shared incentives

Results-only.

A share of the revenue we recover or prevent. That’s it.

  • $0 upfront and no platform fees
  • Free denial audit before you decide
  • 90-day performance guarantee
  • Cancel anytime
Get your free audit

Start with the numbers. Decide with confidence.