Eliott Dear on the One-Claim Test: Why Claims Assassins Starts With One EOB

Most non-par recovery services want a contract signed before they will look at a claim. Eliott Dear built Claims Assassins around the opposite premise. No contract. No retainer. No minimum volume. No transition off your existing billing company. Send one EOB. Eliott Dear will evaluate it, tell you whether there is a case, and if there is, he will build the submission. That is the whole intake.

Why Measurement Before Commitment

Surgeons have been pitched hundreds of recovery services. Most of them demand a contract first, then a chunk of the practice’s entire non-par volume, then a transition process that takes weeks and disrupts the billing team. And the surgeon signs up without knowing whether the company can actually deliver on the promised numbers.

Eliott Dear thinks that is backwards. The surgeon does not know whether the service works until the service produces a result. Demanding a contract before a result is asking the surgeon to commit on faith, which is a structure that protects the recovery service and punishes the provider.

The one-claim test inverts the asymmetry. Send one EOB. Measure the result. Decide whether to send more.

What Happens on the First Claim

Eliott Dear reviews the EOB and the underlying claim data to determine whether the claim is eligible for state IDR, and if so, which state. He pulls the FAIR Health 80th percentile for the procedure and geography. He reviews the operative note if the surgeon is able to share it. He classifies the plan as fully-insured or self-funded. He evaluates whether the insurer’s initial payment determination is below the FAIR Health benchmark by a margin that justifies filing.

If it does, Eliott Dear builds the submission. Medical records, charge justification, provider credentials, and legal argument framing the claim against the specific playbook the insurer is running. Attorney-signed. Filed through the state IDR portal. Followed through to the determination and the 30-day payment window.

If it does not, Eliott Dear tells the surgeon plainly. “This claim is not a good candidate for state IDR, for these specific reasons.” No fee. No pressure. No continuation. Honesty about the match between the claim and the venue is the first gate in the intake.

The Fee

Claims Assassins charges 10% of the improvement. Not 10% of the total recovery. 10% of the amount the state IDR award exceeds the insurer’s original payment. If the original payment was $500 and the state IDR award is $5,500, the improvement is $5,000 and the fee is $500. If there is no improvement, the fee is zero.

That structure aligns the incentives. Eliott Dear only makes money when the surgeon gets additional money. If Claims Assassins does not improve the outcome, Claims Assassins does not get paid. There is no retainer to cover failed filings. There is no minimum billing threshold. There is no subscription fee. There is only the percentage of what Claims Assassins adds.

Scaling After the First Claim

Some surgeons start with one claim and move more over time. Some transition their entire non-par IDR workflow to Eliott Dear. Some just want specific high-value claims handled. All of that works. The point of the one-claim test is not to convert the surgeon into a customer. It is to produce a measurable result so the surgeon can decide, after seeing the outcome, whether to keep sending more claims.

The practices that send more claims do so because the first claim produced a result the billing company could not have produced. That is the filter. If Claims Assassins does not outperform what the surgeon was already getting, the surgeon should keep doing whatever they were doing. If Claims Assassins does outperform, the arithmetic takes care of itself.