Callagy Recovery

What Callagy Recovery does

Callagy Recovery Corporation is a privately held, contingency-based healthcare revenue recovery firm that identifies, arbitrates, and collects on underpaid out-of-network medical claims for hospitals, surgical centers, emergency departments, ambulatory surgical centers, physician groups, and individual providers. The firm operates across all 50 states and 13 federal venues, specializing in federal No Surprises Act (NSA) Independent Dispute Resolution (IDR) arbitration and state-level arbitration frameworks. Callagy advances all filing fees (typically $1,000+ per case) at zero upfront cost to clients and charges a 20% contingent fee on recovered amounts, with a 30-day exit clause.

The company's service portfolio spans 14+ discrete offerings, including federal NSA arbitration representation, state-level arbitration (NY, TX, NJ, and others), IDR submission support, insurance underpayment appeals, emergency care reimbursement, hospital claim recovery, and out-of-network recovery services. Its underlying platform consists of a custom-built, AI-enhanced workflow technology with 100% automated intake, a proprietary case management software incorporating AI and automation, and direct API integrations with Epic and Cerner EHR systems. The platform is HIPAA-compliant and provides real-time tracking and full transparency on every claim, with zero disruption to client billing teams.

Callagy Recovery was formally established as a separate corporate entity in 2024, spun out from Callagy Law (founded 1999 by Sean Callagy, Esq., a two-time Top 100 National Jury Verdict attorney). The company draws on 25+ years of out-of-network collections expertise and in-house legal enforcement capabilities inherited from Callagy Law. It has scaled from 5 to 100+ employees and reports industry-leading operational metrics including a 90%+ arbitration win rate, 13x average increase over initial payer offers, 93% 12-month post-award collection rate (versus ~40% industry average), 98% client retention, $1.6B+ in cumulative recoveries, and $100M+ in monthly client recoveries. Leadership comprises Sean Callagy (President & CEO), Thomas LaGreca, Esq. (Chief Growth Officer & General Counsel), and Mark Winters, MHA (Chief Operating Officer).

Name

Callagy Recovery

Legal name

Callagy Recovery Corporation

Website

https://callagyrecovery.com

Company type

Private

Founded year

1999

Operating status

Operating

Short description

Callagy Recovery is a contingency-based healthcare revenue recovery firm that files, wins, and collects on underpaid out-of-network medical claims for hospitals, surgical centers, and emergency providers across all 50 states under the federal No Surprises Act and state arbitration frameworks.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Recovery Services

NAICS

Collection Agencies (56144)

SIC

Services-Consumer Credit Reporting, Collection Agencies (7320)

akta.pro primary industry

Medical Debt Collection & Revenue Cycle Bad-Debt Recovery (FSAKAJAM)

akta.pro secondary industry

Legal Collections Support (Pre-Lit, Litigation Admin, Judgment Recovery) (BPAAAEAH)

Keywords

• Medical claim recovery
• NSA arbitration services
• Healthcare revenue recovery
• Out-of-network billing
• Insurance underpayment appeals

Headquarters

HQ city

Paramus

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Contingency-Based Arbitration Services: Callagy Recovery operates on a contingency fee model where providers pay no upfront costs. The company advances all filing fees (typically $1,000+/case) and charges a contingency fee only when funds are successfully recovered. This aligns incentives between the company and clients, with the company earning more when clients recover more.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

Callagy Recovery identifies, files, and collects on underpaid, denied, and delayed out-of-network medical claims on behalf of healthcare providers through federal Independent Dispute Resolution (IDR) under the No Surprises Act and state-level arbitration frameworks. Services are delivered under a contingency-fee model where the company advances all filing fees, charges a 20% contingent fee only on recovered funds, and provides in-house attorney oversight on every filing across all 50 states and 13 federal venues.

Product overview

Callagy Recovery offers a comprehensive medical revenue recovery and NSA arbitration platform serving providers across all 50 states and 13 federal venues. The platform consists of multiple interconnected services including Claim Recovery Services (the core identification and recovery process), Arbitration Support (attorney-reviewed IDR submissions with 90%+ win rate), Federal NSA Services (No Surprises Act arbitration representation), Healthcare Revenue Recovery (broad analytical recovery), and State Level Arbitration (state-specific dispute resolution). Additional specialized services cover Emergency Care Reimbursement, Hospital Claim Recovery, Insurance Underpayment Appeals, and Out-of-Network Recovery. The company differentiates through AI-enhanced workflow technology with 100% automated intake and Epic/Cerner API integration, all delivered under a zero-risk model ($0 upfront, 20% contingent fee, 30-day exit) with HIPAA compliance.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Claim Recovery Services Core end-to-end service for identifying, filing, and collecting on underpaid, denied, and delayed out-of-network medical claims through federal IDR and state arbitration, with in-house attorney oversight on every filing. Targeted at hospitals, health systems, surgical centers, physician groups, emergency departments, and independent physicians across all 50 states.
• NSA Arbitration Support (Federal & State-Level)

Quantifiable outcome

• 90%+ win rate in arbitration proceedings
• +6 more outcomes

Named customers7 records

Segments8 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability2 records

Feature4 records

Partnerships

Ten partnerships are on record, tiered minor, core and flagship.

• CNS (Clinical Neuroscience Providers)minorGTM or Marketing PartnerMedical association partnership for clinical neuroscience providers. Callagy Recovery works with this organization to reach potential provider clients and support their members with NSA arbitration and revenue recovery services.
• Medical Society of New JerseyminorGTM or Marketing PartnerState medical society partnership in New Jersey. The organization represents physicians and provides referral opportunities for Callagy Recovery's arbitration services among its member providers.
• Mississippi State Medical AssociationminorGTM or Marketing PartnerState medical association partnership in Mississippi supporting member physicians with out-of-network and NSA arbitration recovery services.
• American Association of Orthopedic ExecutivesminorGTM or Marketing PartnerNational professional organization partnership for orthopedic executives. Provides referral pathway for orthopedic practices seeking NSA arbitration representation.
• Medical Society of State of New YorkminorGTM or Marketing PartnerMajor state medical society partnership in New York representing physicians across multiple specialties. Partnership supports member providers with NSA and state arbitration recovery services.
• Alaska Medical AssociationminorGTM or Marketing PartnerState medical association partnership in Alaska providing NSA arbitration and recovery service referrals for member physicians.
• Medical Association of the State of AlabamaminorGTM or Marketing PartnerState medical association partnership in Alabama supporting member providers with out-of-network claim arbitration and recovery services.
• EpiccoreTechnology or IntegrationEHR integration partnership enabling direct API connectivity with Epic systems. Callagy Recovery integrates seamlessly with Epic EHR for claims data exchange and workflow automation with zero disruption to client billing teams.
• CernercoreTechnology or IntegrationEHR integration partnership enabling direct API connectivity with Cerner systems. Supports seamless integration and automated claims processing with zero disruption to client billing operations.
• Callagy LawflagshipStrategic or Co-development PartnerFounding law firm and strategic partner providing in-house legal enforcement capabilities. Callagy Recovery was born from Callagy Law and leverages 25+ years of out-of-network collections expertise and in-house legal enforcement to not only win awards but collect on them. The law firm's DNA is cited as the key differentiator.

Scale indicators12 records

Recent moves7 records

Expansion highlights6 records

Emerging players

• BHM Healthcare Solutions: BHM Healthcare Solutions is an emerging player in healthcare revenue cycle and denial management, serving hospitals and provider groups with claims recovery services. Comparable to Callagy in addressing underpaid and denied claims but with narrower geographic and regulatory scope.
• Health Management Associates (HMA): Several regional revenue cycle and accounts receivable firms operate in medical claim recovery, often as specialty or emerging players. They overlap with Callagy in hospital/provider RCM services but typically lack Callagy's NSA arbitration specialization and in-house legal enforcement arm.

Broad incumbents

• Zelis: Zelis is a large incumbent healthcare cost-management and payments platform with overlapping capabilities in claims cost containment, provider network management, and OON resolution. Zelis serves many of the same provider clients Callagy targets but as part of a much broader RCM/claims platform.
• Waystar: Waystar is a healthcare revenue cycle technology platform serving hospitals with claims management, denial resolution, and patient payment tools. Comparable to Callagy in addressing underpayment/denial workflows but as a software platform rather than a contingency recovery service.
• Cloudmed (now R1 RCM): Cloudmed (acquired by R1 RCM) specialized in healthcare revenue integrity and underpayment/denial recovery for hospitals. Highly comparable to Callagy Recovery in targeting the same underpaid-claim pain point, though as a tech-enabled service rather than an arbitration specialist.
• Optum (UnitedHealth Group): Optum is the largest healthcare services and RCM platform in the US, serving payers and providers with claims processing, revenue cycle, and analytics. As a payer-affiliated incumbent, Optum is both a competitor (in RCM/collections) and a counterparty (as a major payer) for Callagy Recovery.
• R1 RCM: R1 RCM is a large healthcare revenue cycle management provider serving hospitals and health systems with end-to-end billing and collections services. While not a specialist in NSA arbitration, R1's provider relationships and RCM platform overlap with Callagy's claim recovery niche.
• Experian Health: Experian Health provides patient access, claims management, and collections technology to hospitals and health systems. Comparable to Callagy in serving provider-side revenue recovery workflows, though Experian is broader and more tech-focused than contingency recovery.

Direct peers

• Aspirion: Aspirion is the most direct competitor to Callagy Recovery, specializing in out-of-network revenue recovery and complex claims resolution for hospitals and health systems. Both firms pursue underpaid/denied claims on a contingency basis, with overlapping services in arbitration, denial management, and legal collections support.
• MultiPlan: MultiPlan is a major out-of-network claim negotiation and cost-management platform, directly comparable in serving hospitals and providers seeking to maximize reimbursement on OON claims. Both operate at the intersection of payer/provider disputes in the OON space, though MultiPlan leans more toward repricing while Callagy leans toward arbitration enforcement.

Market position

Strengths4 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Callagy Recovery