HOW WE HELP
Turning Health Insurance Denials Into Approvals
We handle health insurance appeals so providers can focus on patients, billers can focus on workflow, and patients can focus on healing.
The Reality of Appeals
The health insurance appeal process isn't just complicated, it's designed to be overwhelming.
Different insurance types follow different rules. Deadlines vary by state and insurer. Documentation requirements are unclear. Legal language is intentionally confusing. And the entire system relies on people giving up.
The numbers tell the story: fewer than 1% of patients ever appeal their health insurance denials, and only 3% of providers attempt appeals, not because denials are valid, but because the process feels impossible to navigate.
Yet when appeals are filed correctly, 50-90% succeed. The system isn't broken, it's just built to discourage you from trying.
That's where we come in.
of providers attempt appeals
Not because denials are valid, but because the process feels impossible to navigate.
of patients ever appeal a denial
Not because denials are valid, but because the process feels impossible to navigate.
of appeals succeed when filed correctly
The system isn’t broken, it’s built to discourage you from trying.
Our Approach
We've spent years understanding how health insurance companies make decisions and what it takes to overturn them. Our approach combines proven appeal methodologies with modern tools that simplify the complexity.
Every denial is different. Different insurance types, different state regulations, different documentation requirements, different deadlines. We identify which appeal path applies to your specific situation and handle the complexity so you don't have to.
Our process is built on proven ERISA protocols, the federal guidelines that govern most employer-sponsored health plans. These aren't guesses or generic templates. They're the same structured approaches that helped us win appeals when others said it was impossible.
While AI can help speed up certain tasks like document organization, successful appeals require human judgment, medical understanding, case specific deadline tracking and strategic thinking. We use technology where it helps and rely on proven expertise where it matters most.
What to Expect
Here's how we support you from first contact through final submission and follow-up.
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Here's how it works
We review your denial to understand why the claim was denied, and what appeal pathway applies to your situation.
- For providers: We analyze the denial reason, codes, policy language, and medical necessity justifications.
- For billing professionals: Your expertise is billing and coding. Ours is appeals. We take the denial off your plate so you can keep your workflow moving.
- For patients: We translate health insurance jargon into plain language and identify what documentation will strengthen your case.
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As We Build Your Appeal
We gather all documentation needed and construct an appeal that addresses your specific reason for denial. This isn't a one-size-fits-all template. Every appeal is tailored to your unique situation and the insurance company's stated reason for denial.
We handle the confusing parts: Meeting state and federal specific guidelines, formatting documents correctly, and ensuring nothing gets missed that could jeopardize your case.
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Throughout the Process
We manage all communications with the health insurance company and keep you informed throughout.
Why This Works
Our Differentiators
Winning appeals takes more than templates. Here's what makes our approach different.
Automated systems can generate appeal letters, but winning health insurance appeals requires understanding medical context, policy nuances, and strategic case-building. We combine the efficiency of technology with the expertise of someone who's actually won these battles.
This isn't a tech solution looking for a problem to solve. It's a proven methodology developed over years of fighting denials in a real practice, now made accessible to others facing the same challenges.
We know health insurance appeals from the provider side, the billing side, and the patient side. That comprehensive perspective makes us more effective at building successful appeals.
What Success Looks Like
When we succeed, providers recover revenue they've rightfully earned. Billing teams reduce write-offs, collections, and inflated accounts receivable, keeping cash flow moving . Patients access the care they need without financial fear.
But success isn't just about overturning health insurance denials. It's about removing the burden of navigating a system that was designed to exhaust you. You shouldn't have to become an appeals expert. That's our job.
Ready to Get Started?
Whether you're a provider, billing professional, or patient facing a confusing denial, we're here to help.