ReimburseOS
// What Is a Leverage Memo?

Before you start your free memo: here's exactly what you're getting and why it works.

A Leverage Memo is a 2-page negotiation document you submit directly to your payer's provider relations team. It doesn't ask for a meeting. It doesn't leave numbers vague. It presents your specific contracted rates, compares them against your payer's own published federal data, and makes a specific dollar ask for each CPT code, fully sourced, formatted, ready to send.

Built from your payer's own data
Every rate in the memo cites the specific line in your payer's federally-mandated Transparency-in-Coverage MRF filing — the same data hospitals use in negotiations. You're not making a claim. You're quoting their own document back to them.
Specific asks, not general complaints
The memo shows: your current rate, the local peer 75th percentile, and the defensible target — with the math. A specific dollar ask is far harder for a payer to dismiss than "we feel underpaid." It requires a response.
Generates in under 60 seconds
Our system queries your payer's TiC database, benchmarks your CPTs against peer percentiles, and generates the full memo, including the formal renegotiation letter, in real time. Ready to download, print, or email.

"Most independent practices walk into payer negotiations without data. This memo puts the payer's own numbers back in front of them. That asymmetry — the fact that you now have data they assumed you didn't — is where the leverage lives."

— ReimburseOS Methodology, 2026
What's inside the memo (every section)
1. Rate Gap Analysis. Your current contracted rate vs. local peer 25th / median / 75th percentile, per CPT code. Includes sample size (n=) so the payer can't claim the data is cherry-picked.

2. Federal MRF Citation. The exact TiC filing reference: plan name, plan ID, filing date, source URL, and the rate row verbatim. This is the part payers cannot argue with — it's their own submission to the federal government.

3. Medicare PFS Reference. The 2026 CMS Physician Fee Schedule rate for each code. Commercial contracts are negotiated as a multiple of Medicare — showing where you sit relative to that floor strengthens the ask.

4. The Target Rate Ask. A specific, defensible target rate per code, calculated using our methodology: min(local p75, 1.6x Medicare PFS), floored at state median. The math is shown in the memo so the payer understands the basis.

5. Formal Letter. A 1-page professional letter ready to sign and submit. Includes the specific dollar ask, the estimated annual difference, and a clear call to action for the provider relations team.
About the Founder's Promise: The $10,000/month Founder's Promise applies to the paid Practice Audit ($297 founding / $497 list) and Pro subscription, not to the standalone $199 Leverage Memo. The memo is the negotiation tool you use to act on the opportunity a Practice Audit documents. If you have completed a Practice Audit and it did not surface $10,000/month in documented opportunity, contact us for a full refund.
// Generating Your Memo
ReimburseOS is analyzing your data.
Querying federal TiC database · Benchmarking rates · Drafting memo
Payment confirmed — memo request queued
Querying your payer's federal TiC MRF filing…
Computing peer percentiles for your CPT codes…
Loading Medicare PFS 2026 reference rates…
Calculating defensible target rates…
Drafting rate gap analysis and negotiation strategy…
Generating formal leverage letter…
Compiling and formatting final memo…
reimburseos-memo-engine · live analysis
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Memo ready.

Your Leverage Memo has been generated. Loading now…

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Leverage Contract
// LEVERAGE OS · CONTRACT

Your payer contract PDF. Every rate extracted. Market-benchmarked. Memo generated.

Upload your payer contract PDF. We extract every CPT and rate, compare against TiC market data at the 25th, 50th, 75th, and 95th percentile, and generate a renegotiation memo your payer rep cannot argue with. Average documented lift: 7 to 12 percent. 14-day delivery.

Beta · Practice Mode — ReimburseOS is in active customer beta. We do not currently have signed Business Associate Agreements with our infrastructure partners. Until we do, use Practice Mode: de-identified or synthetic claim data only. We automatically scrub obvious PHI patterns before processing, but you are responsible for redaction. Live Mode activates once our BAAs are in place, and you will be notified the moment that happens.
Auto-redacting obvious PHI for your protection.
Full contract extraction
Every CPT, modifier, effective date, termination clause, escalator, and renewal date. Page-cited so you can verify every fact.
TiC market comparison
Every extracted rate benchmarked against the 25th, 50th, 75th, and 95th percentile from federal TiC market data. Real numbers, not estimates.
Renegotiation memo
A 3 to 5 page professional memo: cover, executive summary, code-by-code analysis, market citations, specific dollar asks, and a closing statement your payer rep cannot dismiss.
Red-flag clause review
Termination windows, auto-renewal traps, unilateral rate-change provisions, and other clauses that cost practices money. Flagged and explained.
TiC source citations
Every market rate cited to its federal TiC filing. Plan name, plan ID, filing date, source slug, billing class, and negotiated type included.
Saved to your account
Contract and memo saved securely to your Practice OS account. Access anytime. Auto-imported to your Renewals Calendar when available.
Step 1 of 3

Practice and payer details

Enter the practice NPI and payer name from the contract you're uploading. We'll use this to look up market benchmarks.

Step 2 of 3

Upload your contract PDF

PDF only, 50 MB max. The file is transmitted over TLS and processed server-side. We scrub obvious PHI patterns before any AI call. Never upload patient records.

Step 3 of 3

Notes (optional)

Any context that would help with the analysis: upcoming renewal timeline, payer contact name, specific concerns, codes you need prioritized.

$399
+ 5% of realized lift, capped at $25K
What you get:

Full contract extraction · TiC market benchmarks (p25/p50/p75/p95) · Red-flag clause review · 3 to 5 page renegotiation memo · Letter-paper PDF · 14-day delivery. Average documented lift: 7 to 12%.

Submitting starts the checkout flow. No charge until you confirm. Questions? hello@reimburseos.com
`); doc.close(); // Auto-resize iframe to content height setTimeout(() => { try { const h = doc.body.scrollHeight; if (h > 200) iframe.style.height = (h + 40) + 'px'; } catch {} }, 500); } function copyMemo() { const iframe = document.getElementById('memo-frame'); const html = iframe.contentDocument?.body?.innerHTML || ''; navigator.clipboard.writeText(html).then(() => { const t = document.getElementById('toast'); t.textContent = '✓ Memo HTML copied to clipboard'; t.classList.add('show'); setTimeout(() => t.classList.remove('show'), 2400); }); } // ── Init ───────────────────────────────────────────────────────────── async function init() { const s = await getSession(); if (!s) { window.location.href = '/login'; return; } sessionData = s; // Populate topbar identity const whoEl = document.getElementById('who'); if (whoEl) whoEl.textContent = s.email || ''; const tierEl = document.getElementById('tier'); if (tierEl) { tierEl.textContent = s.is_admin ? 'ADMIN · UNLIMITED' : (s.profile?.tier || 'free').toUpperCase().replace('_', ' '); if (s.is_admin) tierEl.style.cssText += ';background:linear-gradient(135deg,#10b981,#059669);color:#04121a;border-color:#10b981'; } const params = new URLSearchParams(window.location.search); // Cancelled if (params.get('cancelled')) { document.getElementById('form-state').style.display = 'none'; document.getElementById('cancelled-state').style.display = ''; restoreForm(); return; } // Post-payment const reviewId = params.get('review_id') || localStorage.getItem('cnr_review_id'); const sessionId = params.get('session_id'); if (reviewId && sessionId) { localStorage.removeItem('cnr_review_id'); generateMemo(reviewId, sessionId); return; } // Pre-fill NPI from profile const profile = s.profile || {}; if (profile.npi) document.getElementById('npi').value = profile.npi; if (profile.practice_name || s.company_name) document.getElementById('practice-name').value = profile.practice_name || s.company_name || ''; // Restore saved form data if any restoreForm(); // Default CPT rows if (!document.getElementById('cpt-rows').children.length) { addCptRow(); addCptRow(); addCptRow(); } } function restoreForm() { try { const saved = JSON.parse(localStorage.getItem('cnr_form') || 'null'); if (!saved) return; if (saved.npi) document.getElementById('npi').value = saved.npi; if (saved.practice_name) document.getElementById('practice-name').value = saved.practice_name; if (saved.specialty) document.getElementById('specialty').value = saved.specialty; if (saved.payer) document.getElementById('payer').value = saved.payer; if (saved.current_rates && saved.current_rates.length) { document.getElementById('cpt-rows').innerHTML = ''; saved.current_rates.forEach(r => addCptRow(r)); } } catch {} } // ── Live proof chip update ──────────────────────────────────────────── async function refreshProofChips() { try { const r = await fetch('/api/story-status'); const d = await r.json(); const total = d.total_rates; if (total > 100000) { const fmt = total >= 1000000 ? (total / 1000000).toFixed(1).replace(/\.0$/, '') + 'M+' : Math.floor(total / 1000) + 'K+'; document.querySelectorAll('.proof-chip .pval').forEach((el, i) => { if (i === 0) el.textContent = fmt; }); document.querySelectorAll('.sub').forEach(el => { el.innerHTML = el.innerHTML.replace(/[\d,]+K\+|[\d.]+M\+ contracted rates/, fmt + ' contracted rates'); }); } } catch {} } init(); refreshProofChips(); // Escape-to-close + focus trap for memo-limit overlay (function(){ const ov = document.getElementById('memo-limit-overlay'); if (!ov) return; let _lastFocus = null; const origShow = Object.getOwnPropertyDescriptor(HTMLElement.prototype, 'style'); // Watch for display changes via MutationObserver new MutationObserver(() => { if (ov.style.display !== 'none') { _lastFocus = document.activeElement; const first = ov.querySelector('button,a,[tabindex="0"]'); if (first) setTimeout(() => first.focus(), 30); document.addEventListener('keydown', _escClose); ov.addEventListener('keydown', _trap); } else { document.removeEventListener('keydown', _escClose); ov.removeEventListener('keydown', _trap); if (_lastFocus && document.contains(_lastFocus)) _lastFocus.focus(); } }).observe(ov, { attributes: true, attributeFilter: ['style'] }); function _escClose(e) { if (e.key === 'Escape') { ov.style.display = 'none'; } } function _trap(e) { if (e.key !== 'Tab') return; const els = Array.from(ov.querySelectorAll('button,a,[tabindex="0"]')).filter(el => !el.disabled); if (!els.length) return; const first = els[0], last = els[els.length - 1]; if (e.shiftKey) { if (document.activeElement === first) { e.preventDefault(); last.focus(); } } else { if (document.activeElement === last) { e.preventDefault(); first.focus(); } } } })();