Healthcare denial management inside a governed revenue cycle operating system.
DenialOS manages denied claims from intake through recovery — one stage of the revenue cycle operating system, on the same record as the eligibility check, the claim and the remittance that produced them. AI drafts, canonical deadlines are enforced, every payer interaction is logged, and outcomes are recorded — governed by human review at every step.
FHIR EHR Integration Foundation
Connector foundations for Epic, Oracle Health, and athenahealth via FHIR R4, with provenance, checkpointing, and production gates. Live tenant connectivity is unvalidated.
AI-Assisted Appeal Drafts
DenialOS drafts appeal letters from case context. Human review is required before every submission.
Deadline Enforcement
Canonical appeal filing windows are computed by payer, plan, and state. Cases are ordered by deadline urgency automatically.
Evidence Management
Attach denial letters, EOBs, and clinical records to each case. Evidence is synthesized before draft submission.
Team Workflows
Assign cases to billers, coordinators, and managers. Track workload and capacity across the denial queue.
Outcome Tracking
Record approved, denied, and partial outcomes. Feed win-rate data back into denial pattern analysis.
From denial receipt to verified outcome — on one governed record.
Most hospitals manage denials across spreadsheets, email threads, and disconnected systems. DenialOS creates a single workspace where every denial has a case, every case has a deadline, and every outcome is recorded — attached to the claim and the payment it belongs to.
FHIR R4 connector foundations configured per hospital. Activation requires EHR-side app registration, provisioned credentials, and customer UAT evidence.
Every AI-assisted action requires human review. AI drafts — humans approve.
Works across Medicare, Medicaid, commercial, and specialty payers.
Tenant-isolated, HIPAA-aligned architecture for hospital security teams.