Not automation. Understanding. Every case read, analyzed, and argued from scratch.
Pick one. Everything after it is the same engine.
Try a pre-loaded case with all its documents already attached, or upload a real one. Only the starting documents differ.
See the whole path without uploading anything. No login required.
Medical necessity, coding, prior authorisation, documentation, level of service and more. Two to three cases each.
Each case ships with the claim, the EOB, and the clinical notes already sorted and indexed.
Denial reason, CARC/RARC code, payer and billing codes, read straight off the documents. No data entry.
It reads the denial reason, checks medical necessity, and tells you whether the evidence on file is enough.
It picks the line of attack for this case and runs quality checks before writing anything.
An evidence-backed appeal letter, referenced and ready. This is the part that gets the claim paid.
Check the letter against its evidence and export as Word or PDF.
A real denial, including the loop that chases down a missing document. Your first appeal generation is free.
Drop in what you have. Only the EOB or denial letter is required. Everything else is optional.
It sorts whatever you uploaded and pulls the case details out automatically.
The AI reads the actual claim, the EOB, and your documentation together to find what really caused the denial - not a generic response to a code.
Enough evidence and it goes straight to writing. Not enough and it asks you for one specific thing.
The AI names the document and explains exactly why it is needed. Example: Prior treatment history needed - denial cites no evidence of conservative treatment before this procedure.
Upload the one or two documents it named. Nothing else.
New documents get re-read and the gap gets re-tested. If it is still short, it asks again.
Denial analysis, medical necessity, payer policy and guideline matching, then AI validation.
Using the denial details, your documentation, and the payer's own rules, drafts a complete appeal with citations, policy references, and an exhibit list.
Change wording, add context, cut a paragraph. Nothing is final until you say so.
Out in the format your workflow already uses.
Three layers power every appeal.
Denial patterns, appeal guidelines, medical necessity rules, CARC and RARC codes, payer policies, and current state laws. Built and maintained by us. Applied to every case.
Your own payer policies, past successful appeals, and org-specific templates. Upload once. Applied to every case you run.
Documents uploaded for a specific case. Used only for that appeal. Never retained, never shared.
Not a setting you switch on. It applies to everything above.
Documents you upload are used only to build your appeals: never stored beyond the session, never shared with another user, never used to train or improve someone else's results. See the security controls
What we are building next.
Outcome tracking sits with your billing system today. Automated tracking of payer decisions and recovered amounts is being built for a future phase.
Separate starting models for Workers Compensation, physical therapy and orthopedics, plus state-specific variants.
What the AI works from, kept current.
All updated continuously as codes, rules, and laws change.
Upload an EOB or denial letter. That is the only document you need. It tells you what else would help, then drafts the appeal. Your first one is free.