Leveling the playing field against automated insurance denials.
Every year, millions of legitimate medical claims are rejected in seconds by automated carrier algorithms. ClaimAppeal AI equips patients and physicians with statutory precision and clinical evidence to overturn unfair denials.
The Healthcare Denial Asymmetry
Health plans utilize sophisticated algorithmic review engines to reject claims en masse for vague reasons like "not medically necessary" or "experimental."
Appeals Filed
Fewer than 1 in 500 denied patients ever file a formal appeal due to complex paperwork and intimidating bureaucratic jargon.
Overturn Success Rate
When denials are formally challenged with statutory citations and clinical records, carriers reverse up to 70% of adverse determinations.
Drafting Velocity
ClaimAppeal AI synthesizes what used to take hours of legal and medical research into an immediate, citation-backed draft.
Engineered for Legal & Clinical Rigor
We do not write generic letters. Every draft generated by ClaimAppeal AI is anchored in established federal statutes and recognized clinical necessity criteria.
1. Statutory Anchoring
Appeals cite federal protections under ERISA § 503 (29 C.F.R. § 2560.503-1) requiring a full and fair review, carrier disclosure of internal guidelines, and strict procedural compliance under ACA § 2719 for external reviews.
2. Code-Level Rebuttal
Our system parses exact Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) like CO-50 or CO-197, pairing them with recognized benchmarks such as Milliman Care Guidelines (MCG) and InterQual.
3. Health Data Privacy
We guarantee zero AI model training on uploaded clinical documents or EOBs. Protected by AES-256 encryption at rest and Supabase Row-Level Security, your health information remains strictly confidential.
ClaimAppeal AI does not provide medical treatment, diagnoses, or formal legal representation. We are not a law firm or medical provider. Our software empowers consumers, advocates, and providers by converting complex denial notices into structured, professional rebuttal drafts that must be reviewed and submitted directly by the subscriber or their healthcare provider.
Ready to challenge an unfair denial?
Draft your first citation-backed rebuttal letter today. Every new account receives one free personalized appeal with full statutory citations.