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AI Denial Manager

Turn denials into recovered revenue, automatically.

The AI Denial Manager classifies every denial, routes it to the right workflow, and drafts payer-specific appeals — so nothing falls through the cracks and nothing waits in a queue.

Active agent
AI Denial Manager
Classify, route, and appeal denials
40%
reduction in total denials within 90 days
2–3x
improvement in appeal win rate
Significant
recovery of write-offs previously left on the table
The problem

Why this gets built next.

Most denials are recoverable. Most never get worked. The gap is volume — and that gap is exactly where AI agents earn their keep.

What it does

Capabilities, end to end.

Ingests 835s and denial correspondence from every payer

Classifies root cause (eligibility, coding, auth, medical necessity, timely filing, etc.)

Auto-drafts appeal letters with supporting documentation

Prioritizes work queues by recoverable dollar value

Surfaces denial trends by payer, provider, and CPT

How it works

From signal to action in under a minute.

01

Ingest

Reads from your EHR, PM, clearinghouse, or payer feed. Zero rip-and-replace.

02

Reason

The agent applies RCM-trained logic, payer rules, and confidence scoring.

03

Act

Submits, escalates, or hands off to a human — with full audit trail.

Outcomes our customers measure.

40%

reduction in total denials within 90 days

2–3x

improvement in appeal win rate

Significant

recovery of write-offs previously left on the table

FAQ

Questions, answered.

Does the agent file appeals automatically?

It drafts appeals and assembles documentation. A human signs off before submission for the first 90 days; thereafter, you choose the autonomy level.

How accurate is the root-cause classification?

Over 95% on top 20 denial codes across our customer base. Confidence scores attached to every classification.

Can it identify denial trends?

Yes — by payer, provider, CPT, and date range. Trend alerts surface root causes before they balloon.

See AI Denial Manager in action.

Book a 30-minute demo built around your payer mix and specialty.

HIPAA · SOC 2 Type II · BAA included