The claims fighter
Drafts the appeal. A biller files it.
Human-approved · flag-gated per tenantA real day with it
A ₹48,000 cataract claim bounces with CO-97.
Denial Guard decodes it, finds the bundled-procedure root cause, drafts the appeal citing the policy clause — the biller reviews and files it the same day, not next month.
- 1
A claim comes back denied with a CARC/RARC or NHCX code.
- 2
The agent decodes the reason and drafts the appeal, citing the policy clause.
- 3
A biller reviews every draft; high-value claims get a senior reviewer too.
- 4
The appeal goes out the same day, not lost in a shoebox of rejections.
Biller
A workqueue, not a shoebox of rejections.
Finance manager
Denial root-cause analytics.
TPA desk
The sibling TPA Chaser rides the same voice stack to chase authorizations.
- Flag
- aiagents.denial.enabled
- Reads
- The claim and its CARC/RARC or NHCX denial code
- Never writes
- Never files an appeal without a biller's approval
- Channels
- The billing denial workqueue
- Languages
- English
Questions about this agent
Can Denial Guard file an appeal on its own?
No. Every draft goes through a biller's approval before it's filed, and high-value claims above a set threshold need a senior reviewer as well.
How many appeals can it draft in a day?
Up to 500 drafts a day — all still waiting on the same human approval gate.
Does it only handle simple denials?
It decodes the CARC/RARC or NHCX code first, then uses the AI for root-cause analysis, so both routine and complex denials get a drafted appeal.