Claims and Denials
Rejected claims sorted by reason, with corrections and appeals drafted for your billing team to review.
Rejections by reason
- Missing details
- Coding issue
- Pre-approval needed
Appeal draft
Ready for billing review
Overview
When an insurer or TPA rejects a claim, your billing team has to find out why, correct it or appeal it, and send it back within the allowed time. Indite sets up an AI agent that does the sorting and drafting, so your team can focus on reviewing and approving. Nothing is sent without your staff’s approval.
Challenges
Rejections arrive in many formats
Insurer letters, emails and payment notices all explain rejections differently, so each one has to be read separately.
Finding the reason takes time
Staff have to compare each rejection with the original claim and the visit record to see what went wrong.
Appeals need supporting documents
Each appeal has to be backed by details from the patient record, which means searching through files by hand.
Deadlines differ by insurer
Every insurer and TPA sets its own time limit for corrections and appeals, and these are easy to lose track of.
Solution
Understand why a claim was rejected
The agent reads each rejection and groups it by reason, so your team can work through similar cases together.
Find what needs correcting
The agent compares the rejection with the claim and the visit record, points out the missing or incorrect detail and drafts a corrected claim for review.
Prepare appeals for review
The agent drafts appeal letters using information from the patient record. Your billing team reviews, edits and approves each one before it’s sent.
Keep deadlines visible
The agent records the deadline for each claim based on the rules your team sets, and creates a task before it’s due.
Connects with: your billing system and your patient record system (EHR or HIS), through FHIR, APIs, database connections or secure file transfer.
Business Impact
Sorting done before your team starts
Your billing team opens a list of rejections already grouped by reason.
Drafts instead of blank pages
Corrections and appeals start from a prepared draft that your team can review and edit.
Decisions stay with your billing team
No claim or appeal is sent without staff approval.
A clear record for every claim
Each step, edit and approval is logged, so anyone on the team can see where a claim stands.
See how this would work for your team
Tell us how it works today. We’ll show you how an AI agent could handle it, where your staff stays in control and what it would cost.