Stop handing denied biologic revenue back to the payer.
AppealOS turns a denial letter and chart note into a submission-ready appeal packet — the letter, the billing codes, the missing-evidence checklist — grounded in the payer’s own policy. Your staff reviews in 10 minutes instead of building for an hour.
- Staff review required on every packet
- Every claim cited to a source document
- Redacted documents accepted
Aetna · Commercial
Skyrizi (risankizumab) 150mg
Prior authorization is the most quantified admin pain in medicine.
prior authorizations per physician, every week
of staff + physician time weekly
of requests often or always denied
of physicians say PA drives burnout
74% of physicians say denials have risen over five years — and every appeal your staff can’t get to is revenue handed back to the payer.
Source: AMA 2025 Prior Authorization Physician Survey (released May 2026).
Denial in. Submission-ready packet out.
Upload
The denial letter, chart note, labs, prior-treatment history.
Understand
AppealOS extracts the denial reason, deadline, and codes, each with a confidence score.
Check the payer’s own rulebook
Every policy criterion rendered met, unmet, or missing, tied to evidence in your documents.
Packet
Letter, ICD-10/CPT/J-codes, authorization-duration request, and a checklist of anything still missing. Your staff reviews, signs, submits.
Human-review-first, always. Nothing leaves AppealOS without staff sign-off, and every clinical claim carries a citation.
One case one complete, defensible packet
Appeal letter
Cites the payer’s own policy language.
Codes & duration
ICD-10 / CPT / J-code / NDC, plus an explicit duration request.
Missing-evidence checklist
Flags gaps before the payer says so.
Criteria table
Met / unmet / unknown, linked to evidence.
Export & cover sheet
Fax-ready PDF, disclaimer built in.
Outcome tracking
Overturn rate and $ recovered, by payer and drug.
GPT writes letters. AppealOS ships packets.
The AI is a commodity. Everything around it is the product.
A payer policy library, kept current.
The actual medical policies for the biologics you prescribe, per payer — versioned and effective-dated. Your appeal quotes their rules, not generic language.
A completeness verifier.
No criterion is marked satisfied without cited evidence. Codes, duration, follow-up — the exact fields generic AI drops — are enforced.
Proof, not promises.
Every packet tracked to outcome: overturn rates and recovered revenue, by payer and drug.
Judge the output, not the pitch.
Send one redacted denial (patient name, DOB, and record number removed) with the relevant chart note. We return the complete appeal packet — free, no demo call, no commitment. If it wouldn’t have saved your team 30+ minutes, delete it and forget us.
We’ll reply within one business day with 2-minute redaction instructions and a secure way to share. Please don’t attach or paste patient information.
Pricing that one recovered claim pays for.
Starter
- Up to 10 packets a month
- 1–3 providers
- The core workflow: upload → criteria check → packet
Early pilot practices get concierge onboarding included — we load your payers and drugs and train your billing team. First appeal free either way.
Built for healthcare from day one.
Evaluation uses redacted documents only — nothing in your free packet contains protected health information.
Pilot practices operate under a signed BAA, with encryption in transit and at rest, role-based access, and full audit logging on HIPAA-ready infrastructure.
Your documents are never used to train AI models.
A human reviews everything. AppealOS drafts and checks; your staff decides. It is not a medical device and does not provide medical advice.
Straight answers.
No. AppealOS is an administrative drafting and checking tool. It assembles evidence your clinicians already documented and formats it against the payer’s published criteria. A member of your staff reviews and signs everything before it goes anywhere.
Those tools are strongest at initiating prior authorizations. AppealOS focuses on what happens after a denial lands: rebuilding the case against the payer’s own policy, with the codes, duration request, and missing-evidence checklist that make an appeal submission-ready. Many practices use both.
At launch: the major dermatology biologics (Skyrizi, Dupixent, Cosentyx, Taltz, adalimumab and biosimilars, and more) across the largest national payers. During onboarding we load the specific payers and plans your practice sees most — that’s part of setup.
One denial letter and the relevant chart note, with patient identifiers removed (name, date of birth, record number, address). We’ll send you 2-minute redaction instructions when you reach out.
Your free evaluation uses redacted documents, which contain no protected health information. Paying pilot practices sign a BAA with us, and all patient data is handled on encrypted, access-controlled, audit-logged infrastructure.
No — and you should be suspicious of anyone who does. What we guarantee is a complete, policy-grounded, staff-reviewed packet in a fraction of the time, and transparent tracking of your outcomes.
Minutes to generate. Most practices spend about 10 minutes reviewing and finalizing, versus the 45–60 minutes it takes to build an appeal by hand.
Pilot onboarding includes loading your payers’ policies, configuring your drugs and providers, and training your billing team. For early pilot practices, it’s included.
One redacted denial. That’s the whole ask.
“I’m Suhaas — a solo engineer who builds AI workflow systems (my current product runs in production today). Early practices get direct access to the person writing the code.” suhaas@rabiqdigital.com