Stop Losing Revenue to Claim Denials
Upload your denial letters. Our AI agents read, analyze, fix coding errors, generate appeal letters, and tell you exactly what to submit — all in one click.
We only get paid when you get paid.
Denials are growing faster than your team can rework them
Payers are denying more claims, more aggressively, every year. Your RCM team is already stretched thin. Without AI in the loop, recovered revenue slips through the cracks every single day.
Denied claims represent roughly 15% of all submitted claims, with an average of $1.4M in lost revenue per hospital annually.
Manual appeal workflows take 30-60 days from denial to resolution, tying up cash flow and staff time.
Most practices lack the staff capacity to appeal every denial — meaning most denied revenue is simply written off.
Labor, paper, postage, and follow-up calls cost $18-$25 per appeal — often more than the claim is worth.
From denial to appeal in three steps
No new software to install. No EHR rip-and-replace. Upload, analyze, resubmit.
Upload denial letter or claim
Drag-and-drop PDFs, EOB scans, 835 files, or paste claim JSON. PHI is masked before any AI call — no Protected Health Information ever leaves your tenant in raw form.
Six agents analyze in parallel
Each agent works its scope: Eligibility verifies coverage, Coding re-checks codes, Denial decodes the EOB, Appeal drafts the letter. Findings merge into a single worklist.
Review, fix, and resubmit
You see a prioritized fix list with one-click resubmission. Appeal letters are ready to print or e-submit. Every recommendation cites the source line in your original document.
Six AI agents. One revenue cycle.
Each agent has a defined job, strict scope boundaries, and anti-hallucination guardrails. No agent invents codes, no agent fabricates clinical detail — they cite source documents for every recommendation.
Eligibility Agent
Verify coverage before service
Real-time eligibility verification against payer APIs. Catches COB issues, terminated policies, and benefit limits before the patient walks in the door.
- ›270/271 EDI transactions
- ›COB hierarchy resolution
- ›Benefit accumulator checks
Pre-Auth Agent
Get prior authorization right the first time
Auto-generates PA packets with clinical justification, attaches required docs, and tracks payer SLA. Cuts PA denials by 70%+ on average.
- ›Da Vinci PAS / FHIR R4
- ›Auto-attached clinical notes
- ›SLA breach alerts
Coding Agent
ICD-10 / CPT / HCPCS suggestions
Reads clinical notes and suggests code sets with confidence scores. Flags unspecified codes, sex-conflict edits, and medical-necessity mismatches.
- ›ICD-10-CM + ICD-10-AM (KSA)
- ›NCCI edit checks
- ›Modifier suggestions
Claims Agent
Pre-submission scrubbing
13 rule families covering benefit, clinical, and operational edits. Returns a clean-claim score, a verdict, and a prioritized fix list before you submit.
- ›13 NPHIES rule families
- ›100+ US payer rules
- ›Finding-level severity
Denial Agent
Diagnose root cause & draft appeal
Parses the 835/EOB, decodes CARC/RARC, identifies the winning appeal strategy, and drafts a bilingual appeal letter ready for review.
- ›CARC / RARC decoder
- ›Strategy-by-code library
- ›Bilingual EN / AR appeals
Payment Posting Agent
Auto-post & flag short-pays
Reads 835s, posts payments, and flags contractual adjustments vs. underpayments. Surfaces patterns of payer underpayment worth pursuing.
- ›835 auto-posting
- ›Underpayment detection
- ›Payer-pattern analytics
Pay per claim, or pay only when you win
No subscriptions. No setup fees. Pick the tier that fits your volume — or skip straight to L4 and let us run the whole recovery operation.
Scan & Score
Pre-submission scrubbing only. Submit your claims, get a clean-claim score and a fix-list back.
- 13 NPHIES rule families + 100+ US payer rules
- Clean-claim score 0-100
- Severity-tagged findings
- Email delivery of report
- 48-hour turnaround
Fix & Appeal
Full denial recovery. We analyze denials, fix coding, and draft bilingual appeal letters ready to send.
- Everything in L1, plus:
- Denial root-cause analysis (CARC/RARC)
- Bilingual EN / AR appeal letters
- Coding re-work with citations
- Resubmission packet ready
- 24-hour turnaround
EHR Auto-Fix
Full integration with your EHR / clearinghouse. Agents run on every claim, in real time, inside your existing workflow.
- Everything in L2, plus:
- Epic / Cerner / Athena integration
- Real-time claim scrubbing
- Auto-resubmission workflow
- Dedicated success engineer
- Custom payer rule packs
All tiers include HIPAA-compliant handling · PHI masking · SOC 2-ready audit logs · Cancel anytime
Try the scrubber, then book a recovery audit
Run the claim scrubber live — no signup. When you're ready, book a 30-minute meeting and we'll pull a sample of your denial backlog and show you exactly what we'd recover.
Run the claim scrubber
{
"encounterType": "inpatient",
"serviceDate": "2026-06-12",
"memberId": "",
"nationalId": "1234567890",
"payer": "BUPA-Arabia",
"providerLicense": "MOH-12345",
"procedures": [
{
"code": "99213",
"modifiers": [
"25"
]
},
{
"code": "12000",
"modifiers": []
}
],
"diagnoses": [
"Z34.83",
"O80"
]
}Request a meeting
Prefer to grab a slot directly? Email Rajesh or call +1 (555) 555-0100
Built for US today. Built for KSA tomorrow.
One agent framework, two regulatory environments. We are live in the US now and bringing 15 specialized agents to NPHIES in Q4 2026.
US Healthcare
- HIPAA Compliant
- US Payer Patterns
- EHR Integration (Epic / Cerner / Athena)
- Medicare, Medicaid, Commercial, MA
KSA / NPHIES
- FHIR R4, Da Vinci PAS, ZATCA, CCHI
- Bilingual English + Arabic
- ICD-10-AM coding standard
- Native NPHIES integration