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Appeals Drafting Agent

Turns a denial reason code and the clinical record into a payer-ready appeal letter in minutes.

Who it's for
Utilization review and appeals teams at providers and payers.
What it replaces
Manual appeal letter drafting against payer-specific policy language.
<div class="hx-demo-box" style="margin-top:40px;border:1px solid #D2D2CA;border-radius:12px;overflow:hidden;background:#fff;box-shadow:0 12px 32px -12px rgba(23,25,21,.18)"><div style="background:#F7F7F3;border-bottom:1px solid #D2D2CA;padding:10px 20px;display:flex;align-items:center;gap:10px"><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="font-size:12px;color:#8B9086;margin-left:6px">denials.local/appeal/draft-{{ caseNum }}</span></div><div style="display:flex"><div style="flex:0 0 280px;border-right:1px solid #E4E4DE;padding:20px;background:#FAFAF7"><div style="font-size:11px;letter-spacing:0.06em;text-transform:uppercase;color:#8B9086;margin-bottom:12px;font-weight:600">Denial detail</div><div style="display:flex;flex-direction:column;gap:10px;font-size:13px;color:#171915"><div style="display:flex;justify-content:space-between"><span style="color:#8B9086">Payer</span><span>UnitedHealthcare</span></div><div style="display:flex;justify-content:space-between"><span style="color:#8B9086">Reason code</span><span>CO-50</span></div><div style="display:flex;justify-content:space-between"><span style="color:#8B9086">CPT</span><span>27447</span></div><div style="display:flex;justify-content:space-between"><span style="color:#8B9086">Reason</span><span>Not medically necessary</span></div></div></div><div style="flex:1;padding:20px 24px;display:flex;flex-direction:column;align-items:center;justify-content:center;min-height:220px"><sc-if value="{{ isScanning }}"><div style="font-size:14px;color:#8B9086;animation:fadeUp .3s ease both">Matching clinical documentation against payer policy language...</div></sc-if><sc-if value="{{ isDone }}"><div style="width:100%;max-width:420px;background:#FAFAF7;border-radius:8px;padding:18px 20px;animation:pop .4s ease both;font-size:13px;line-height:1.6;color:#171915"><div style="font-weight:700;margin-bottom:8px">Re: Appeal of claim denial, case #{{ caseNum }}</div><div>Per policy 4.12, total knee arthroplasty is medically necessary given documented Kellgren-Lawrence grade 4 osteoarthritis and failure of 6 months of conservative treatment, as recorded in the attached progress notes dated...</div></div></sc-if></div></div></div>
window.HX_DEMOS=window.HX_DEMOS||{}; window.HX_DEMOS["app"]=function(Base){ const CYCLE_SEC=9; class Comp_app extends Base { state={t:0,caseNum:5104,name:'',email:'',org:'',formSubmitted:false}; componentDidMount(){ this._start=Date.now(); this._iv=setInterval(()=>{ if((Date.now()-this._start)/1000>=CYCLE_SEC){clearInterval(this._iv);return;} const elapsed=(Date.now()-this._start)/1000; const t=elapsed%CYCLE_SEC; const cycle=Math.floor(elapsed/CYCLE_SEC); this.setState({t,caseNum:5104+cycle}); },150); } componentWillUnmount(){clearInterval(this._iv);} onName=(e)=>this.setState({name:e.currentTarget.value}); onEmail=(e)=>this.setState({email:e.currentTarget.value}); onOrg=(e)=>this.setState({org:e.currentTarget.value}); submit=()=>this.setState({formSubmitted:true}); renderVals(){ const scanning=this.state.t<4; return {caseNum:this.state.caseNum,stageLabel:scanning?'Drafting...':'Draft ready',isScanning:scanning,isDone:!scanning, name:this.state.name,onName:this.onName,email:this.state.email,onEmail:this.onEmail,org:this.state.org,onOrg:this.onOrg,submit:this.submit, formOpen:!this.state.formSubmitted,formSubmitted:this.state.formSubmitted,nameSuffix:this.state.name?', '+this.state.name.split(' ')[0]:''}; } } return Comp_app; };
Draft one of your own appeals →
Free to start. No credit card.

How the Appeals Drafting Agent works

1
Reads the denial
Reads the denial
Pulls the denial reason code and the clinical documentation tied to the claim.
2
Matches payer policy
Matches payer policy
Cross-references the denial against payer-specific medical necessity or coding policy.
3
Drafts the appeal
Drafts the appeal
Writes a payer-ready appeal letter citing the specific clinical evidence and policy language.
4
Step label
Routes for sign-off
Sends the draft to the appeals coordinator for review and submission.
5
Step label
12 min
to draft a payer-ready appeal, versus 2 hours
100%
of letters cite the specific payer policy clause
48 hrs
faster turnaround inside the appeal window

Stop drafting appeals from scratch.

Start free, we'll draft a batch of your real appeals so you can see the quality.

Cites the exact policy clause behind every argument
Lives inside your existing denial management workflow
Free for your first 20 appeals, no credit card
Starts free
Takes about 30 seconds. No sales deck required.
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