Denial Management and Appeals on Steroid
Built for Defensible Revenue Recovery
Neurex AI transforms denied claims into recoverable revenue using clinical intelligence, payer policy awareness, and human-in-the-loop automation. From prevention to appeal, every decision is explainable, compliant, and audit-ready.
Denial Recovery Queue
Real-time appeal tracking
Medical Necessity Denial
Payer: UHC | Amount: $12,450
AI Evidence Extraction
4 supporting documents linked
Appeal Generated
Ready for review | 94% confidence
85%
Appeal Success
$2.4M
Recovered MTD
4.2hrs
Avg. Prep Time
Used by health systems and RCM partners across the US
Designed for Epic, Cerner, Meditech, and major clearinghouses
Denials Are No Longer an Operational Problem. They Are a Financial Risk.
Rising medical necessity denials, DRG downgrades, and payer variability are overwhelming traditional appeals teams. Manual processes cannot keep pace with denial volume or complexity.
65%
Denials tied to clinical documentation or authorization issues
$5M+
Average annual revenue at risk per mid-sized hospital
72hrs
Average time to prepare a clinical appeal manually
40%
Of appeals never submitted due to resource constraints
The Real Cost
When appeals are delayed, under-resourced, or inconsistent, recoverable revenue becomes permanent write-offs. The average health system leaves millions on the table annually due to preventable appeal failures.
Intelligent Denial Resolution, End to End
From denial detection to appeal submission, Neurex AI automates the research, evidence gathering, and letter generation that consume your team's time.
Denial Root Cause Detection
AI identifies the clinical, policy, or procedural origin of each denial, reducing research time from hours to seconds.
Automated Appeal Generation
Generates defensible appeal letters using clinical evidence, payer policy citations, and historical success patterns.
Payer Policy Intelligence
Continuously updated payer behavior models that adjust appeal strategy based on real-time policy interpretation.
Clinical Evidence Linking
Automatically extracts and links clinical documentation to appeal arguments for medical necessity support.
Appeal Prioritization Engine
Ranks denials by recovery potential, appeal deadline, and payer responsiveness for optimal resource allocation.
Outcome Tracking & Learning
Closed-loop feedback system that learns from appeal outcomes to continuously improve success rates.
From Denial to Recovery in Six Steps
A closed-loop system that learns from every outcome to continuously improve appeal success rates.
Step 01
Denial Ingestion & Classification
Denials flow in from clearinghouses and payer portals. AI classifies by type, payer, service line, and root cause within seconds.
Step 02
Clinical Evidence Extraction
Neurex AI analyzes the complete patient record to identify documentation supporting medical necessity and coding accuracy.
Step 03
Payer Policy Matching
The platform cross-references denial reason codes with payer-specific policies, LCD/NCDs, and historical appeal outcomes.
Step 04
Appeal Strategy & Generation
AI recommends optimal appeal approach and generates compliant appeal letters with linked clinical evidence.
Step 05
Human Review & Submission
Appeals specialists review AI recommendations, make adjustments, and submit through integrated payer channels.
Step 06
Outcome Learning Loop
Results feed back into the model, improving future predictions, timing recommendations, and appeal language.
Measurable Impact on Revenue Recovery
Organizations using Neurex AI for denial management see significant improvements across key performance indicators.
45%
Improvement in appeal success rate
70%
Reduction in appeal preparation time
$2.8M
Average annual recovery improvement
3.2x
ROI within first year
Purpose-Built for Healthcare Revenue Cycle
Traditional Appeals Teams
- Manual research and letter writing
- Inconsistent appeal quality
- Limited payer policy visibility
- Reactive, post-denial workflow
Generic AI Solutions
- Lack healthcare-specific training
- No payer policy integration
- Cannot link clinical evidence
- Limited to text generation
Neurex AI
- Healthcare-native AI models
- Real-time payer policy awareness
- Clinical evidence extraction & linking
- End-to-end denial lifecycle management
Common Questions
Stop Leaving Revenue on the Table
See how Neurex AI can transform your denial management process and recover revenue that's rightfully yours.
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