Denial appeals software inside the revenue cycle operating system.
Appeals are one stage of the revenue cycle — and in DenialOS they run on the same governed record as the claim that produced them: denial intake from EOBs and 835s, evidence attachment, AI-drafted appeal language under human review, canonical filing deadlines by payer and plan, submission tracking, and outcomes recorded back onto the account.
AI Appeal Drafting
DenialOS drafts appeal language from clinical context, denial codes, and payer rules. Human review required before submission.
Evidence Attachment
Attach denial letters, clinical records, and supporting documents to each appeal case for complete submission packets.
Deadline Tracking
Appeal filing windows are tracked by payer, plan, and state. Cases ordered by deadline urgency automatically.
Human Review Gate
Every AI draft requires human approval before submission. No appeal is sent without a human in the loop.
Submission Tracking
Track appeal submissions, acknowledgements, and responses. Log every payer interaction in the case record.
Team Assignment
Assign appeals to billers, coordinators, and managers. Track workload and capacity across the queue.
From denial receipt to filed appeal — and back into the cycle.
One stage of the revenue cycle operating system. The case record carries the original charge, the payer decision, the appeal and the outcome together, so the appeal history stays attached to the money it belongs to.
Upload denial letter, EOB, or 835. DenialOS parses and creates a structured appeal case.
Attach clinical records, authorization letters, and supporting documentation to the case.
DenialOS generates appeal language from available context. Human reviews and edits before approval.
File the appeal within deadline. Log acknowledgement and set follow-up reminders.
Record approved, denied, or partial outcomes. Feed data back into denial pattern analysis.
AI drafts appeal language. Humans approve. Every AI-assisted action is logged in the audit trail.
FHIR R4 connector foundations bring clinical context into appeal cases. Live tenant connectivity is unvalidated.
Track appeals across Redetermination, Reconsideration, ALJ, and beyond with deadline reminders at every level.