Medical claim denials — tracked, governed, and worked to a recorded outcome.
DenialOS gives hospital billing teams a structured workspace for medical claim denials — one stage of the revenue cycle operating system, on the same record as the eligibility check and the claim itself, from intake and appeal drafting through payer follow-up and outcome recording. Includes FHIR R4 EHR connector foundations for Epic, Oracle Health, and athenahealth; live tenant connectivity is unvalidated until EHR-side app registration, provisioned credentials, and customer UAT evidence exist.
Denial Intake
Upload EOBs, 835s, and denial letters. DenialOS previews parsed records before confirmed case creation.
AI Appeal Drafts
Generate appeal letters from clinical context, denial codes, and payer rules. Human review required before submission.
Deadline Governance
Canonical appeal filing windows are computed by payer and plan. The work queue is ordered by deadline urgency automatically.
Revenue Recovery
Record approved, denied, and partial outcomes, and track recovery by denial type and payer — all observed data, not estimates.
Evidence Management
Attach denial letters, clinical records, and supporting documents to each case for complete appeal packets.
Team Assignment
Assign cases to billers, coordinators, and managers. Track workload and capacity across the denial queue.
Every step is tracked. Every outcome is recorded.
One stage of the revenue cycle operating system — the denial lifecycle never leaves the record it belongs to.
Upload 835s, EOBs, and denial letters. DenialOS parses and previews records before case creation.
Each denial becomes a structured case with deadline, owner, payer, and denial code.
DenialOS drafts appeal language from clinical context and payer rules. Human review is required.
Log every payer call, email, and written response in the payer interaction ledger.
Approved, denied, and partial outcomes are recorded, fed back into denial pattern analysis, and written onto the account so the money lineage stays intact.
DenialOS implements FHIR R4 connector foundations for Epic, Oracle Health, and athenahealth, with provenance, checkpointing, and production gates. Live tenant connectivity is unvalidated until EHR-side app registration, provisioned credentials, and customer UAT evidence exist.
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