Know before you submit. Rescue the denial.
PA readiness checks and appeal packets for dermatology biologics — cited to the payer's policy and the patient's chart, reviewed and signed by your provider.
The criteria check on a synthetic case — live product, not a mockup. Each row cites the chart and the policy page.
Your staff reviews everything.
Every letter is approved by a person in your practice before export unlocks.
Nothing submits itself.
You send the payer copy through the payer's own channel. AppealOS does not transmit anything, to anyone.
We stand behind the packet — not the payer's verdict.
Complete, cited, defensible. The decision stays the payer's — and we record what came back.
Before you submit and after a denial — the same check, against the same policy.
PA readiness check
Appeal packet
The highlighted step is the same in both lanes: a person in your practice approves, and only then does export unlock.
Both lanes in detail, with screenshots →Most appeals win. Most denials are never appealed.
of appealed Medicare Advantage prior authorization denials were fully or partially overturned in 2024.
Source: KFF analysis of 2024 CMS Medicare Advantage data, published January 2026.
of physicians say they always appeal a prior authorization denial.
Source: AMA 2024 Prior Authorization Physician Survey (released 2025).
The gap is administrative: time, staff, and the difficulty of arguing against a policy nobody has read. AppealOS reads the policy, checks the chart against it, and puts a cited packet in front of your reviewer.
![Page 1 of the letter of medical necessity for synthetic case #10: letterhead, governing policy #1009 with effective date, and section I with [C1] and [C2] citation markers](/_next/image?url=%2F_next%2Fstatic%2Fmedia%2Fdoc-lmn-packet-p1.2tu5xrgtu_lgg.png&w=3840&q=90&dpl=dpl_2WQ9bKWQ1bf8Y8wDFZukrvF35h5h)
Letter of medical necessity, page 1 — synthetic case. Every [C#] is a citation to the record.
Read the documents, not the pitch.
Three downloadable sample documents from synthetic cases — a readiness report, a letter of medical necessity, and an appeal packet. The patients and the practice are invented; the payer policy is a real, public document.
Every case ends with an outcome record.
What was submitted, what came back, and how long it took — recorded on every case and reviewed with you.
Dashboard, Appeals lane — live product capture on synthetic data.
The people who carry the biologic queue.
Office managers
One contract, one BAA, one flat price per location.
Coordinators & billing staff
The criteria table, the gather list, the staff actions, the review gate — daily.
Multi-location groups
One policy library and one review standard across locations. Group pricing.
Five things practices ask first.
No. AppealOS is an administrative drafting and checking tool. It assembles evidence your clinicians already documented and checks it against the payer's published criteria. A person in your practice reviews and signs everything before it goes anywhere.
Those tools are strongest at initiating prior authorizations. AppealOS checks whether the chart actually supports the request before you submit, and rebuilds the case against the payer's own policy after a denial. A practice can use both.
The dermatology biologics — Skyrizi, Dupixent, Cosentyx, Taltz, adalimumab and its biosimilars, and others — for any payer that publishes its criteria. We load the policies your practice sees before your first case.
No — and you should be suspicious of anyone who does. We stand behind the packet: complete, cited to the payer's policy and the patient's chart, reviewed by your staff. The decision is the payer's, and we record what came back.
Access is invite-only; there is no self-serve sign-up. It starts with a 20-minute walkthrough. If it fits, we sign a Business Associate Agreement before any patient information enters the system, load your payers' policies, and work the first cases with your coordinator.
Anything else — ask a person.
Book a 20-minute walkthrough.
A synthetic case end to end — the criteria check, the gather list, the review gate — then a conversation about your payers and drugs.