AI-powered agent that handles the entire appeal process automatically—from denial analysis to appeal letter generation—without human intervention.
September 18, 2024
DataRovers today announced the release of Smart Appeals Agent, an AI-powered system that automates the entire appeal generation process from start to finish—without requiring human intervention.
The Smart Appeals Agent handles every step of creating an appeal automatically. Staff no longer need to manually review denials, search through records, or write appeal letters. The agent does it all.
Step 1: Analyze the Denial
The agent automatically reads and understands the denial. It identifies the denial reason code, payer requirements, and what's needed to overturn the decision.
Step 2: Extract Supporting Evidence
The agent scans through clinical documentation and pulls all relevant information that supports the appeal. It knows what to look for based on the denial type and payer criteria.
Step 3: Generate the Appeal Letter
Using the denial analysis and extracted evidence, the agent writes a complete, ready-to-submit appeal letter. The letter is structured to address the specific denial reason with supporting documentation.
"The Smart Appeals Agent removes the manual work entirely. It reads the denial, finds the evidence, and writes the appeal—all automatically. Your team just reviews and submits."
Appeal preparation has traditionally been one of the most time-consuming tasks in revenue cycle management. Staff spend hours per appeal reading through denials, searching records, and crafting responses. This creates backlogs and delays revenue recovery.
With Smart Appeals Agent, the entire process happens in minutes instead of hours. Appeals are generated consistently and completely, reducing errors and improving overturn rates.
• Zero manual work — Agent handles everything automatically
• Faster turnaround — Appeals generated in minutes, not hours
• Consistent quality — Every appeal is thorough and complete
• Higher success rates — Better evidence organization improves outcomes
• Staff focus on exceptions — Team reviews instead of creates
"We built Smart Appeals Agent to eliminate the administrative burden completely. Healthcare teams shouldn't spend hours on paperwork. Let the AI handle it so your team can focus on what matters."
Smart Appeals Agent is available now to all DataRovers customers. Request a demo at datarovers.com to see the fully automated appeal process in action.
See how Smart Appeals Agent handles the entire appeal process automatically.
Agent automatically reads and parses the denial notification. Identifies the denial reason code, payer, and specific requirements for overturning the decision.
Automatically scans through all available clinical documentation to find information relevant to the denial. No manual searching required.
Pulls out specific data points, clinical notes, and supporting information that directly address the denial reason.
Structures the evidence according to what the specific payer looks for, making the appeal more likely to succeed.
Generates a complete, professional appeal letter with all supporting evidence properly cited and formatted for submission.
Completed appeal is ready for quick staff review and submission. No creation work needed—just verify and send.
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Watch the fully automated appeal generation process—no human intervention required.
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