Back to MarketplaceContact Sales
Denial Triage & Review
Denial Analyst
FeaturedA comprehensive denial triage and clinical review tool. Upload denial CSV files and the system automatically classifies each case by CARC code, determines appealability, computes win probability and DOPS priority scores, and routes cases to appropriate work queues. Run AI-powered clinical reviews that analyze case data, identify evidence gaps, and recommend whether to proceed with an appeal. Includes split-panel evidence viewing for uploaded clinical documents.
Features
Bulk CSV denial ingestion with CARC-to-category mapping
Automated appealability and win probability scoring
AI clinical review with evidence extraction
Split-panel evidence viewer with source citations
Priority queue with DOPS/urgency scoring
Evidence gap identification with severity levels
Tags
AppealsDenialsTriageClinical ReviewCARCEvidence
Ready for real data?
Take this prototype to production with SSO, RBAC, HIPAA-compliant infrastructure, and your own data integrations.
SOC 2 Type II
SSO & RBAC
EHR / claims integrations
Custom model fine-tuning
API Playground
Use synthetic data only. Do not submit real patient records or PHI in the API Playground.