AppealGenius automates the insurance appeal process for behavioral health facilities — cutting hours of manual work down to minutes with AI-generated, payer-specific appeal letters.
Every denied claim that goes uncontested is revenue left on the table. Manual processes eat hours of skilled labor, miss deadlines, and produce inconsistent results.
2-3 hours
per appeal with manual processes
$50-100+
in labor cost per appeal
35%
average overturn rate without tools
A complete platform purpose-built for behavioral health billing teams.
Payer-specific, evidence-based appeal letters citing relevant clinical criteria, CMS policies, and case-specific evidence — in seconds.
Authorization forms (AOR, DOR) populated automatically from claim data. E-sign right in the browser.
Track L1 Reconsideration → L2 Appeal → L3 External Review with full timeline and status tracking.
Upload denial letters, EOBs, or clinical notes. AI extracts patient info, denial codes, and claim details automatically.
Track claim amounts, overturn rates, team performance, and recovery trends to optimize your process.
Auto-calculated appeal windows with reminders. Never miss a filing deadline again.
Our guided workflow takes you from a denied claim to a submission-ready appeal packet in under 30 minutes.
Drop a denial letter, EOB, or claim form. AI extracts patient info, claim details, denial codes, and billed amounts automatically.
Review extracted data, select payer and facility. System auto-suggests appeal deadlines based on payer rules.
Attach clinical notes, treatment plans, and supporting documentation. Everything stays organized and categorized.
AI writes a professional, payer-specific appeal letter citing ASAM criteria, medical necessity guidelines, and your evidence.
Auto-fill payer forms, e-sign, and assemble the complete appeal packet as a single PDF — ready to submit.
Conservative estimates based on 40 appeals per month at $5,000 average claim value.
80 hrs
Monthly labor saved
960 hours/year
5%+
Overturn rate improvement
From 35% to 40%+
$120K+
Additional annual recovery
From improved overturn rate
10x
Return on investment
Pays for itself in weeks
Start with a free pilot — no commitment, no credit card required.
+ $2,500 one-time setup
Setup & onboarding included
All plans include a 2-week free pilot with real appeals. No commitment required.
Everything you need to know about AppealGenius.
AppealGenius uses AI trained on thousands of successful appeal letters to generate payer-specific arguments. It cites relevant ASAM criteria, CMS policies, and your clinical evidence to build a compelling case for medical necessity.
Yes. AppealGenius is built with HIPAA-readiness in mind. All data is encrypted in transit and at rest. We never use your patient data for AI training, and you can delete records at any time.
We support all major commercial payers (UnitedHealthcare, Aetna, Cigna, BCBS, Humana, Anthem), plus Medicare, Medicaid, and TRICARE. Our system includes payer-specific form templates and appeal guidelines.
The pilot runs for 2 weeks and includes full access to all features. Process real appeals and see measurable results before making any commitment. No credit card required to start.
Most facilities see 10x+ ROI. With 40 appeals/month at $5,000 average claim value, even a 5% improvement in overturn rate (35% → 40%) recovers $120,000+ annually — far exceeding the annual subscription cost.
Yes! All plans include unlimited team members. Each user gets their own login, and you can track individual performance and assign appeals across your billing team.
Absolutely. Annual plans include full onboarding and training. All plans include priority email support, and we offer screen-sharing sessions to help you get the most out of the platform.
We support 835/ERA file imports to automatically populate appeal data from your existing claims. API integrations for popular practice management systems are on our roadmap.
Start your free pilot today. See real results with your actual appeals before committing to anything.