Stop leaving denied revenue on the table.
NDS reads the remittance advice — EOB or ERA — identifies the denials and denial codes, gathers relevant supporting information, references applicable payer guidelines, and drafts a complete appeal letter tailored to the denial type and payer. What takes skilled staff 30–60 minutes to research and write, the AI completes in minutes. Every appeal is reviewed by your team before submission. The AI does the research and the writing. Your people make the final call.
Claim denials are rising across the industry. Yet most RCM teams handle appeals manually — researching denial codes, pulling supporting documentation, cross-referencing payer guidelines, and writing letters from scratch or from outdated templates. A single appeal can take 30 minutes to an hour of skilled staff time.
Because of this cost, most organizations focus their appeals effort on high-dollar denials. That makes sense — but it means a large volume of smaller denials are simply written off. Not because they couldn’t be overturned, but because the cost of manually appealing them exceeds the recovery. Collectively, these neglected denials represent significant lost revenue.
At the same time, high-dollar denials are often complex and require experienced staff with nuanced payer knowledge. AI doesn’t replace that expertise. But it can take on the volume of routine, lower-dollar denials that your team can’t get to — making it economical to appeal claims that were previously written off.
Reads remittance advice — 835 files or denial correspondence — to identify denied claims, denial codes, and denial reasons. Can also ingest denials via HL7 interface with the client’s EHR where direct 835 access is not available.
Classifies denials by type — coding, authorization, eligibility, bundling, contractual, medical necessity, and more — and flags filing deadlines so nothing expires before your team can act.
The system is configurable to your parameters — you define which payers, which denial codes, and which dollar thresholds the AI should work on. Not every denial gets an AI appeal. You control the scope.
Gathers the supporting information relevant to the denial type — whether that’s clinical documentation from your EHR, coding logic, authorization records, or submission timelines.
References applicable payer guidelines to identify the basis for appeal and the supporting language needed.
Prepares the case by assembling the denial details, supporting evidence, and payer-specific context needed to generate a compelling appeal.
Drafts a complete appeal letter using generative AI — tailored to the denial type, the payer, and the specific supporting information gathered for that claim.
Each letter is original and payer-specific — not generated from generic templates. The AI structures the argument, cites the relevant evidence, and references payer guidelines where applicable.
The output is a submission-ready appeal with supporting documentation references — ready for your team’s review.
Every AI-generated appeal is presented to your team in a review interface before submission. Your team can read the full draft, edit any section, add or remove supporting documentation, approve, or reject — with full revision history maintained. The AI drafts. Your people decide. Nothing goes to a payer without human sign-off.
Tracks filing deadlines and submission status across all active appeals — giving your team visibility into what’s been filed, what’s pending, and what’s approaching deadline.
The denials your team writes off because they’re not worth the manual effort — AI makes them economical to appeal. Individually small, collectively significant.
What takes skilled staff 30–60 minutes — researching, writing, compiling — the AI completes in minutes. Your team reviews and approves instead of building from scratch.
Every appeal is tailored to the denial type and the payer — referencing relevant guidelines and structuring arguments accordingly. No generic templates that payers see through immediately.
Automated deadline tracking ensures appeal-eligible denials are flagged before they expire. No more revenue lost to missed filing windows.
Let the AI handle the volume of routine denials. Your experienced staff can focus on the high-dollar, complex cases that require nuanced judgment and payer expertise.
Configure which payers, denial codes, and dollar thresholds the AI works on. Start narrow, expand as confidence grows. Your organization sets the rules.
Most appeal automation tools take a denial code, match it to a template, and fill in the blanks. NDS goes further — our AI researches the denial, gathers supporting information, references payer guidelines, and writes an original appeal tailored to the specific situation.
Most competitors offer a letter generation tool. NDS delivers a complete appeal pipeline — from denial intake and classification, through research and evidence gathering, to letter generation, human review, and submission tracking. The letter is the output. The pipeline is the difference.
Our generative AI doesn’t fill in templates. It drafts original appeal letters that structure the argument around the specific denial type, reference relevant payer guidelines, and cite the supporting information gathered for that claim — in professional language appropriate for payer review.
This isn’t about replacing your appeals team. It’s about recovering the revenue they don’t have time to pursue. AI appeals are most effective on the volume of routine, lower-dollar denials that are currently written off — making it economical to appeal claims that were previously left on the table.
You define the scope — which payers, which denial codes, which dollar thresholds. The system works within parameters you set, and every appeal goes through human review before submission. Autonomy is earned over time, not assumed from day one.
NDS AI-Generated Appeals is designed for healthcare organizations where a significant volume of appeal-eligible denials go unworked — not because they can’t be overturned, but because the team doesn’t have the bandwidth to file them all.
Multi-specialty physician groups and large practices
Standalone hospitals and hospital-based billing operations
Hospital groups and Integrated Delivery Networks (IDNs)
RCM companies managing appeals at scale across multiple clients
Organizations looking to reduce dependency on outsourced appeals teams
Share your sample remittance data and your organization’s business rules, and we’ll build a proof of concept showing how NDS reads your denials and generates submission-ready appeal letters — tailored to your payers and denial types. No setup fees. No commitment.
Have questions about AI-generated appeals?
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