Intelligence
Trained on 14,820 historical claims · Updated daily
Model v2.4 · 83.1% accuracy
Real-Time Denial Predictor
Payer
CPT Code
Diagnosis
AI Appeal Letter Generator
Claim
Select a claim and click “Generate Letter” to draft an AI-powered appeal using claim history and clinical guidelines...
Denial Pattern Analysis
AI-detected trends across payer × reason combinations
Updated 2h ago
Aetna·Medical Necessity
+6%warning
Medical Necessity denials from Aetna trending upward. May indicate a policy change — verify current coverage guidelines.
3 claims affected
Aetna·Pre-Auth Missing
+9%warning
2 claims denied for missing pre-auth with Aetna. Consider adding pre-auth verification to intake workflow.
2 claims affected
UnitedHealthcare·Timely Filing
+5%warning
Timely Filing denials from UnitedHealthcare trending upward. May indicate a policy change — verify current coverage guidelines.
2 claims affected
UnitedHealthcare·Medical Necessity
+11%warning
Medical Necessity denials from UnitedHealthcare trending upward. May indicate a policy change — verify current coverage guidelines.
2 claims affected
Cigna·Medical Necessity
+5%warning
Medical Necessity denials from Cigna trending upward. May indicate a policy change — verify current coverage guidelines.
2 claims affected
Network Benchmark
Compared against 127 facilities
UnitedHealthcare+6% above avg
Top 25%: 91%Avg: 94%You: 100%
Attach clinical notes and imaging upfront
Medicare+8% above avg
Top 25%: 85%Avg: 92%You: 100%
Attach clinical notes and imaging upfront
Cigna+6% above avg
Top 25%: 65%Avg: 69%You: 75%
Attach clinical notes and imaging upfront
Humana+7% above avg
Top 25%: 62%Avg: 68%You: 75%
Attach clinical notes and imaging upfront
Denial Rate by Payer
UnitedHealthcare
100%
Medicare
100%
Cigna
75%
Humana
75%
Aetna
67%
BCBS
0%
Medicaid
0%
Top Denial Reasons · Last 90 Days
Medical Necessity
12
Pre-Auth Missing
4
Bundling/Coding Error
2
Duplicate Claim
2
Timely Filing
2