Denial Prediction + Auto-Appeal — Predict denials. Auto-generate appeals.
Two products working together. One prevents denials. The other fights them.
The short version
Two products working together. One prevents denials. The other fights them.
The prediction side scores every claim before submission. High risk? Your team gets an alert with specific reasons — not just a red flag, but an explanation: "This claim is likely to be denied because [payer] has been rejecting [procedure] when billed with [modifier] for [diagnosis]." That gives you time to correct or document before the claim even leaves.
The auto-appeal side kicks in when denials do happen. It generates appeal letters using payer-specific templates, attaches relevant clinical documentation and policy references, and routes everything for review and submission. What used to take a specialist 45 minutes per appeal takes about 5.
The model gets smarter over time. Every denial outcome feeds back into the prediction engine, which means your denial rate keeps dropping the longer you use it.
Features that actually move the needle
Pre-submission risk scoring
Every outbound claim gets a denial-probability score, with a specific reason — not just a red flag. Your team gets a chance to fix it before submission.
Auto-generated appeal letters
Payer-specific templates, clinical documentation, policy references — all pulled together and routed for review. 45 minutes per appeal becomes 5.
Continuous learning
Every denial outcome feeds back into the model. Your denial rate keeps dropping as the system learns your payers' actual behavior.
Specialist-grade with intern-grade speed
Appeals that match what your most senior specialist would write, generated in a fraction of the time.
Practices where denial rate is a known leak — especially those with high payer-mix complexity or specialty coding edges.
The rest of the product suite
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