Built for small practices. Not big firms.

Most billing services charge a flat monthly fee or a percentage of total collections — structures that pay regardless of whether they do the hard work or the easy work. Contingency pricing inverts that. We earn only when revenue actually lands in your account. If the audit finds nothing recoverable, you owe nothing. If appeals succeed, we take a share of what we brought back.

This is not a discount model. It is an alignment model. Our incentive is exactly the same as yours: recover the maximum amount of legitimate revenue as efficiently as possible. We have no reason to pad the work, chase uncollectible claims, or file appeals we do not believe in.

We work exclusively with physical therapy and mental health practices — not because we cannot work elsewhere, but because depth in a specialty produces better outcomes than surface coverage across ten of them.

PT billing has specific denial patterns: Modifier 59 disputes, visit-limit medical necessity reviews, ICD-10 specificity requirements that vary by payer. Mental health has its own: parity law arguments, telehealth transition complexity, prior authorization gaps that did not exist five years ago.

Understanding these patterns deeply — knowing which payer appeals succeed and which do not, which documentation gaps are fixable and which are not — is the difference between a 30% appeal success rate and a 70% one.

A generalist denial management firm spreads that knowledge across every specialty. We do not.

Relvio Health is founder-led. The difference from the BPO model is not scale — it is accountability. One person is responsible for your account, reachable by email or phone, who knows your denial history. Your patients' data stays in US-based, BAA-covered infrastructure, accessed remotely under strict, audited controls.

For small practices, this matters. You do not have the time or budget to manage a vendor relationship on top of running a practice. You need someone you can reach, who knows your account, and who can give you a straight answer about a denial status in under a minute. That is what we build the business around.

We are small by design. We serve a limited number of practices at a time so that each one gets real attention. We do not take on volume we cannot service well.