We do the work. You make the calls that need you.
Our agents identify, build, file, and chase every denied claim. The judgment calls, the clinical ones and the genuinely uncertain, always come to you. That's the line.
You decide how hands-on to be. Change it anytime.
Insurers are denying with AI now. You can't fight that by hand.
Health plans are pouring money into AI — not to pay claims, but to deny them faster and at scale, with less and less human review. Against that, a busy biller or a basic software tool is a knife to a gunfight. The only answer is a better AI on your side.
It's documented on both sides of the market. ProPublica reported that Cigna's system let its own doctors deny over 300,000 claims in two months — about 1.2 seconds per claim, in batches, without opening the files. And a 2024 U.S. Senate investigation found the largest Medicare Advantage insurers increased their use of AI for coverage reviews, driving denials up as human review fell. (ProPublica, 2023; U.S. Senate Permanent Subcommittee on Investigations, 2024)
You can't win this by hand anymore. That's not pessimism — it's the new math. The practices that recover are the ones that bring a better AI to the fight.
How your data reaches us, and how little leaves your hands
You pick the handoff. We take only the minimum necessary, never your full charts, and a BAA is signed before any of it moves.
FAQ
Do I have to approve every appeal?
That's up to you. You set how hands-on to be: review every appeal before it goes out, or let the crew file the routine ones it's already proven it can win and route the judgment calls (clinical, and anything it's unsure of) to you. Clinical appeals always come back to you, whatever your setting. The crew only files on its own within the limits you set, and only after a real track record against that payer, so early on, you're in the loop on nearly everything, and you remain the responsible filer on everything submitted under your name.
How does our claim data actually reach you?
You choose the handoff: a secure upload of your denial and remittance data (EOB/835), or a read-only connection to your clearinghouse or practice-management system. Either way we take only the minimum necessary: denial and remittance data, not your full charts. There's no new system for your staff to operate and no change to how your biller works.
What about appeals that need a chart note or a peer-to-peer call?
When an appeal turns on clinical documentation, you provide (or approve pulling) only the specific note for the specific claim being appealed, nothing more. When a denial turns on a peer-to-peer call or physician attestation, the agents build the entire package (talking points, guideline citations, prior-treatment history) and your physician makes the call. The AI does the preparation; the clinical judgment stays with your doctor.
How long until we see recovered money?
You'll see appeals moving in your dashboard early in the engagement, well before money lands, so you always know it's working. Recoveries then follow each payer's own appeal timelines. You're never in the dark, and you're never billed until a dollar is actually recovered.
Why does using AI agents change the economics?
Initial claim denial rates hit 11.8% in 2024 and keep climbing, yet roughly two in three denials are recoverable (Experian Health's 2025 State of Claims finds 41% of providers now see 10%+ of claims denied). The catch is that appealing a small-dollar or complex denial by hand costs more than the claim is worth, so practices write it off. Agents collapse the cost of building and filing an appeal to near zero, so the entire written-off backlog becomes worth recovering.
Is it secure and HIPAA-compliant?
We operate as a HIPAA business associate: we sign a Business Associate Agreement (BAA) before accessing any claim data, run under HIPAA-compliant controls, encrypt data in transit and at rest, audit-log every access, and never sell your data or use it to train any AI model. See our Security & HIPAA page for details.