Paveo
Specialty drug denial recovery

We win back the specialty drug denials your team doesn't have time to appeal.

Paveo is a service, not software. There is nothing to install and nobody on your team gets a login. You give us access, we do the appeal work, and you pay only if the denial is overturned.

Ask for the free 5-case audit See the full site

Two jobs on your side. Everything else on ours.

The last version of this business left four jobs with the customer — choose, send, review, file. That is selling half a job, so we stopped doing it.

What Paveo does

  • Pull the denial and the clinical record ourselves, once you've given us access.
  • Find the exact criterion the denial turned on, in that payer's published policy.
  • Draft the appeal, with every clinical claim traced to a page in your notes.
  • File it with the payer as your delegate, and chase status until there's a decision.
  • Tell you plainly when we judge a case unwinnable — and why.

What you do

  • Give us delegated access to the payer portals your team already uses.
  • Approve the finished appeal — one decision on completed work, not a second review of it.
  • Nothing else. We handle the filing, the follow-up and the record-keeping.
Nothing is ever filed without a named human approval. A person on your side signs off, and a Paveo operator files as your delegate. The software never submits anything on its own.

Why the work is worth doing

Every figure below comes from one dataset, with its primary source named.

7.7% of 53 million Medicare Advantage prior authorization requests were denied in 2024 KFF
11.5% of those denials were ever appealed KFF
80.7% of the denials that were appealed came back partially or fully overturned KFF
74 min of a clinical pharmacist's time to work a single appealed authorization AJMC

The first three figures are Medicare Advantage prior authorization only, and we don't quote them as if they described every payer. Denials get overturned far more often than they get appealed — the gap is time nobody has, not weak cases.

You pay only when we win

Two prices, because two different people are out of pocket when a specialty drug is denied. No seats, no licence, no subscription.

Independent specialty pharmacy
$199
per overturned denial

Pharmacy benefit — pens, pills, self-injectables, adjudicated by a PBM. The pharmacy eats the denial, so the fee is a flat number per win.

Clinic or in-office infusion
8%
of the recovered claim

Buy-and-bill — you paid for the vial before reimbursement was certain, so a denial has one unambiguous dollar value. No minimum and no cap.

A denial we don't win costs you nothing. Start with a free audit of five closed, denied, de-identified cases: which ones we judge were winnable, the exact payer criterion each turned on cited to its source, and a drafted appeal for the strongest. We'll send you a short list of what to strip first — about two minutes a case — so nothing identifying ever reaches us.

Who we work with

US independent specialty pharmacies, and clinics or practices running in-office infusion. Our verified payer-policy coverage is deepest in rheumatology, dermatology, inflammatory bowel disease and haemophilia, across the major commercial payers and PBMs.

If your volume sits mostly outside that, we'll say so and scope to the part that fits — or tell you we're not the right fit. We never approximate a payer's policy to win a deal.