The whole path

From a denied claim to a ready-to-send appeal.

Upload the denial. AI builds the case. You send it.

Two ways in

Two ways to get started.

See a Sample Case

Pick a preloaded case from common denial categories. The full flow runs instantly. Nothing to upload.

Medical Necessity
Coding errors
Prior Authorization
Workers Compensation
Documentation issues
Level of Service

Run a sample case

Denial Insights & Analytics

Payer Rules & Guidelines

Try Your Own Case

Upload your own EOB or denial letter. AI analyzes your real case and drafts the appeal.

Only the EOB is required to start
Add more documents to strengthen the appeal
First appeal generation is free

Upload your denial

What happens automatically

The moment a denial lands.

It classifies what you uploaded, reads the denial against the claim and the EOB, works out what caused it, and drafts the appeal. All of that happens before anyone on your team opens it.

Upload EOB / DenialAI ClassifiesDenial AnalyzedEvidence CheckAppeal DraftedReview & ExportRevenue Recovered

Step by step

The full process, explained.

Step 1 - Upload

Drop in your EOB or denial letter. Add clinical notes, prior auth records, or fee schedules if you have them. More context means a stronger appeal.

Workers Compensation specialists: upload the EOBR and DWC forms here. Physical therapy and orthopedics teams: attach the treatment notes and authorization.

Step 2 - AI Classifies

Bill Matters reads every document uploaded, sorts them by type, and extracts key case information automatically.

No filing, labelling or data entry on your side. Drop the documents in and the AI works out what it is looking at.

Step 3 - Denial Analyzed

The AI identifies the real denial reason. Not just the surface code. It checks the claim, the payer rules, and current state insurance laws.

The AI is trained on ICD-10, CPT and HCPCS billing codes, payer-specific coverage rules, denial reason codes, and state-specific insurance law, updated as they change.

Step 4 - Evidence Check

If the appeal needs a document not yet provided, the AI names it and explains exactly why. You upload only what is specifically needed.

Not a generic warning. Something like: "Prior treatment history is needed because this denial cites lack of conservative treatment before the requested procedure."

Step 6 - Review and Export

Your team reads the draft. Edit anything. Export as Word or PDF and submit through your existing process.

Nothing is sent automatically. Your team controls what goes out and when.

Revenue recovered

The appeal goes to the payer through the process you already use, and the money you had already earned comes back into the practice.

Outcome tracking runs on your side or through your billing system today. Automated outcome tracking is being built for a future phase.

Step 5 - Appeal Drafted

A payer-specific appeal is generated with evidence, citations, policy references, and an exhibit list. Built for that case, not a template.

Written from your claim, not a templateIt uses the actual denial details, the documentation you provided, and the payer's own rules. Every appeal is written for that specific case.

It argues backThe letter answers the payer's stated reason directly, with the evidence that contradicts it placed right beside the claim.

Current on state law and insurance codesState insurance law, CARC and RARC denial codes, and CPT, ICD-10 and HCPCS coding are kept current for you. When a rule changes, the appeals change with it, and nobody on your team has to track it.

Citations and exhibits attachedPolicy references, citations and an exhibit list are assembled with the letter, so you submit a complete package the first time.

Missing documents drafted where possibleWhere the appeal needs a supporting document that can be generated from what you have already provided, the AI drafts that too.

Minutes instead of hoursYour team opens a finished draft instead of a blank page. That is how the same people file more appeals and get more of the money back.

State insurance lawCARC / RARC codesCPT, ICD-10, HCPCSPayer policiesUpdated as they change

Know what you are looking at

Every denial has a reason. Here is what it usually is.

Most rejected bills are not random. They fall into a short list, and once you know which one you are looking at, the fix gets a lot clearer.

Missing or invalid prior authorisation

Authorisation was missing, wrong, or never came through in time. Most common with imaging, surgery, specialty drugs and therapy. Fixing it afterwards often means starting the request again.

Eligibility issues

Coverage had lapsed, changed, or never applied to that service on that date. Working out which plan was actually active can take longer than the appeal.

Coding errors

Wrong or outdated CPT, ICD-10 or HCPCS codes, including ones that trip a bundling edit. One mismatched code flips a whole claim from payable to rejected.

Timely filing exceeded

The claim went out after the payer's deadline, sometimes by a day or two. Most payers treat this as final, which makes the filing window the least forgiving rule in the system.

Duplicate claim submission

A corrected claim gets flagged as a duplicate, even though it was resubmitted specifically to fix an earlier error. The payer sees matching details and rejects the newer one.

Not enough documentation for medical necessity

Clinical notes do not clearly support what was billed. Payers increasingly use their own AI to catch this at scale, so the gap has to be closed with real documentation, not a better argument.

Coordination of benefits errors

The claim went to the wrong payer when another plan should have paid first. It can bounce between payers more than once before anyone sorts out who owes what.

Not sure which one you have?

Run a denial through and see what the analysis names as the real reason. Your first appeal is free.

Try it

Try it on a real denial

See the appeal it writes for your claim.

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.

Try It Free Book a Demo