AppealIQ is the only platform that automates the complete insurance denial lifecycle — medications, procedures, imaging, and claims already submitted — built for independent specialty clinics.
Free for the first 10 clinics · No credit card · 24-hour response
Prior auth requests completed per physician per week on average
Hours per week staff spend on authorization paperwork instead of patients
Of all claims were denied in 2024 — up 2.4% year over year and climbing
Of appealed denials are overturned — yet most denied claims are never challenged
Every hour on hold with a payer is revenue delayed. Every unappealed denial is revenue abandoned.
Payers have deployed AI algorithms that flag and deny prior authorization requests up to 16x faster than human reviewers. Your manual, fax-based process cannot keep pace with a system engineered to outrun it.
40% of specialty practices have hired staff whose only job is managing prior authorizations — a full salary dedicated entirely to fighting insurers instead of caring for patients or growing your practice.
Effective appeals require specialty-specific clinical guidelines, knowledge of payer medical policies, and the ability to argue medical necessity in language a medical director will approve. Billing staff alone cannot do this. A physician-built AI can.
The majority of denied claims are never appealed — not because the care wasn't appropriate, but because writing an effective appeal is too time-consuming and clinically demanding. Every unappealed denial is money your clinic earned and simply gave back.
Most tools handle one piece of the problem. AppealIQ handles all four — because your revenue doesn't stop at medications.
AI drafts specialty-specific PA letters for biologics, DMARDs, and specialty drugs — citing the exact clinical guidelines your payer's medical director needs to see.
Prior authorizations for surgeries, infusions, advanced imaging, and DME — the entire category that medication-only tools ignore. Works with any EHR or without one.
For claims already submitted and denied. AppealIQ reads the denial reason code, classifies the denial type, and generates a clinically sound appeal letter in under 3 minutes.
See which payers deny your clinic most, which CPT codes get flagged, which denial reasons are most common, and what documentation patterns improve your approval rate over time.
A note on medication-only tools: Several platforms automate medication prior auths — and they do it well. But some are funded by pharmaceutical manufacturers, which means they may prioritize the drugs those companies pay them to support. AppealIQ has no pharmaceutical partnerships. We work exclusively for your clinic's financial interests — across every denial type, every drug, every procedure, every payer.
No templates. No copy-paste. AI trained on clinical guidelines, payer policies, and specialty-specific evidence drafts the exact letter your case requires — and a physician reviews before anything goes out.
Paste the denial code, upload the EOB, or enter the PA details. AppealIQ classifies the type — medical necessity, step therapy, prior auth, or experimental — and identifies the right clinical pathway automatically.
Our physician-built AI generates a specialty-specific letter citing the exact clinical guidelines, peer-reviewed evidence, and payer policy language your case requires. Every letter is tailored to your patient's specific denial — not pulled from a generic template.
Your physician reviews the draft in under 2 minutes. Download as PDF, submit directly, or copy into your existing workflow. Track every PA and appeal in your dashboard and watch your denial patterns improve over time.
Trained on ACR, AGA, AAD, AAN, ENDO, and NCCN guidelines — not generic medical templates.
Biologics and DMARDs face the most aggressive payer scrutiny in medicine. We cite ACR guidelines and document prior DMARD failures with precision.
IBD biologics require documented step therapy through conventional agents. We build the clinical narrative and track prior treatment history automatically.
Biologics for psoriasis and atopic dermatitis face aggressive formulary restrictions. We document PASI scores, BSA involvement, and conventional therapy failures.
MS therapies, CGRP inhibitors for migraine, and anti-epileptic drugs require detailed clinical narratives. We cite AAN guidelines and relapse history.
CGMs, insulin pumps, and GLP-1 agents face formulary restrictions and step therapy requirements. We document HbA1c trends and hypoglycemia risk.
Advanced imaging, genomic testing, and targeted therapies face the most scrutinized PA processes in medicine. Our AI cites NCCN guidelines with clinical precision.
We designed AppealIQ so that patient privacy is structurally protected — not just promised in a policy document.
Patient data is used to generate your letter and immediately discarded. We never persist PHI on our servers. Your patients' data never leaves your control.
All data transmitted to AppealIQ is encrypted end-to-end using TLS 1.3. No plain-text patient information ever travels across our network.
Every clinic signs a Business Associate Agreement before accessing AppealIQ. This is a legal requirement — and we make it immediate, not buried in an onboarding checklist.
Built on cloud infrastructure with signed HIPAA BAAs. Every vendor in our stack operates under the same compliance requirements we do.
Role-based access ensures only authorized staff can view clinical details. Every action generates a full audit trail for your compliance records.
Every AI-generated letter requires a licensed physician to review before submission. AppealIQ augments clinical judgment — it never replaces it.
Why zero PHI storage matters for your clinic: Most healthcare SaaS tools store patient data to improve their AI over time. AppealIQ does not. We generate and return your letter without retaining a single piece of patient information. This eliminates an entire category of HIPAA liability for your practice — and means your patients are never exposed in a data breach on our end.
I've seen attendings stay late writing appeal letters that their billing staff had no way to write — because arguing medical necessity requires clinical knowledge. I've also watched practices lose thousands of dollars every month in unappealed denials because nobody had the time or training to fight back. I built AppealIQ to give every independent specialty clinic the clinical firepower of a full-time physician advocate — at a fraction of the cost.
Yes — and we go further than the minimum. AppealIQ is designed on HIPAA-compliant infrastructure with encrypted data transmission, role-based access controls, and full audit logging. We sign a Business Associate Agreement (BAA) with every clinic before you access the platform. Most critically, we do not store any patient health information on our servers. Your patient data is used to generate the letter and immediately discarded — eliminating the most common source of HIPAA risk in healthcare software.
AppealIQ works with any EHR — or no EHR at all. Unlike some tools that require e-prescribing integration or a specific vendor, AppealIQ accepts information through a simple web interface or document upload. You don't need to change your existing workflow. Future updates will include direct EHR integrations for clinics that want them.
A licensed physician at your clinic reviews every AI-generated letter before it is submitted. AppealIQ is designed to reduce physician review time from 20–30 minutes to under 2 minutes — by handling the research, guideline-citing, and drafting. The physician remains the clinical decision-maker and signatory. AppealIQ is a tool that augments clinical judgment, never replaces it.
Billing companies handle claims submission and basic follow-up. Very few have the clinical expertise to write effective denial appeals — especially for specialty-specific denials involving biologics, medical necessity arguments, or step therapy disputes. AppealIQ fills that gap with physician-level clinical knowledge. Many early clinics use both: their billing company for claims processing, and AppealIQ for appeals that require clinical argumentation their billing team cannot provide.
The first 10 clinics in our early access program receive full access free during the beta period — no credit card required. After beta, pricing will be based on practice size and volume, in the range of $199–$299 per month per practice. Given that a single successful denial appeal often recovers hundreds to thousands of dollars in otherwise-abandoned revenue, the ROI for most clinics is immediate.
Three things. First, scope — most tools handle only medication prior authorizations. AppealIQ covers medications, procedures, imaging, and claims already denied. Second, clinical depth — built by a physician, using specialty-specific guidelines (ACR, AGA, AAD, AAN, NCCN), not generic templates. Third, independence — we have no pharmaceutical partnerships. We work for your clinic's financial interests, not a drug manufacturer's commercial ones.
No commitment. No credit card. We'll schedule a 20-minute call within 24 hours to understand your clinic's specific denial patterns and get you set up.
Takes 90 seconds. We'll respond within 24 hours.
We'll reach out within 24 hours to schedule your onboarding call. Check your inbox — and your spam folder just in case.