Denial Doctor
Turning denied insurance claims into recovered revenue, in minutes instead of hours.
The problem
A multi-location physical therapy practice was losing significant revenue to denied insurance claims. Billing staff spent close to an hour per appeal—researching denial codes, finding regulatory citations, and drafting letters that met payer requirements.
Most denials went unchallenged simply because there was not enough time to fight every one. The appeals that did get written varied in quality depending on who had bandwidth that week.
What we built
An AI-powered tool that reads a denied claim, identifies the denial code, researches relevant regulations and payer policies, and generates a professional appeal letter with the correct clinical and billing references.
- •EOB upload with automatic extraction of claim details and denial codes
- •Denial code intelligence mapped to appeal strategy and required documentation
- •Appeal letter generation with inline citations and editable draft
- •ICD-10 and CPT suggestion ranked by evidence from the patient record
- •One-click fax to payer with full audit logging for compliance
A closer look
How it works
Staff upload a denial or enter claim details manually. The system identifies why the payer rejected the claim and pulls the clinical context needed to respond—not generic boilerplate, but argument structure tied to that denial category.
AI drafts the letter in seconds; a biller reviews, adjusts tone, and sends. HIPAA-compliant logging tracks every access and export. The human always approves before anything leaves the practice.
The outcome
Appeals move from backlog item to same-day task instead of something that waits for a slow week.
The practice can challenge denials consistently instead of triaging only the largest ones.
Letter quality is consistent regardless of which biller handles the account.
Need something like this?
Tell us what's broken in your workflow. We'll tell you honestly if we can build it.
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