The #1 AI Appeals Platform for US Healthcare

Stop leaving
$262 billion
on the table

IQAppeals turns every insurance denial into a data-driven appeal — with the exact documentation checklist, AI-predicted overturn probability, and a pre-written appeal letter in under 60 seconds.

Start free trial — no credit card See how it works ↓
63%
Average appeal overturn rate
when fully documented
65%
Of denials are never
appealed — lost revenue
$262B
In US claim denials
every year (CMS 2024)
60s
To generate a complete
AI appeal letter
CO-50 Medical Necessity Prior Authorization CO-4 72% Medicare ALJ Overturn Payer Intelligence Built-In AI Letter Generator HIPAA Compliant 14 Payers Covered 238 CARC Codes Mapped CO-16 Claim Info Missing First Level Appeals CO-50 Medical Necessity Prior Authorization CO-4 72% Medicare ALJ Overturn Payer Intelligence Built-In AI Letter Generator HIPAA Compliant 14 Payers Covered 238 CARC Codes Mapped CO-16 Claim Info Missing First Level Appeals
The problem

Most providers are
losing a fight they
could easily win

0
% of denied claims are
never appealed.

That's your revenue, walking out the door — every single month.
📋
No one knows what documents to submit Every denial needs different proof. Most billers guess, submit incomplete files, and lose winnable appeals.
⏱️
Deadlines are missed constantly UHC gives you 60 days. Humana's L2 is only 30. Miss the window — you forfeit the claim entirely.
🎲
No way to know if it's even worth appealing PR-204 has an 18% overturn rate. CO-16 has 87%. Without data, every appeal is a coin flip.
✍️
Writing appeal letters takes hours Each letter requires clinical language, regulatory citations, and payer-specific formatting. Billers burn hours on each one.
How it works

From denial to decision
in four steps

IQAppeals automates the entire appeals workflow — from reading the denial code off your EOB to generating a submission-ready letter with every supporting document identified.



Built-in intelligence from
CMS Medicare Claims Data
OIG Improper Payment Reports
KFF ACA Marketplace Data
AHIMA ICD-10 Guidelines
X12 835 CARC/RARC Full Library
HFMA Benchmarking Reports
47,000+ historical appeals
01

Enter or import your denial

Paste your CARC/RARC code or upload your 835 ERA file. IQAppeals reads the denial reason, payer, billed amount, and patient data automatically.

Auto 835 import
02

Get your documentation checklist

Instantly see every document required for that specific denial code + payer combination. No guessing — the exact records, the specific content required, and where to find them.

238 CARC codes covered
03

See your AI overturn probability

Our model scores the appeal across 12 weighted factors — diagnosis severity, documentation completeness, payer history, appeal level — and tells you exactly what would push it higher.

XGBoost + rules engine
04

Generate & submit your appeal letter

One click generates a payer-specific appeal letter with clinical language, regulatory citations (LCD/NCD), and all supporting documentation referenced. Download and submit.

Claude AI powered
Features

Everything you need.
Nothing you don't.

🎯

AI Overturn Probability Score

Every denial gets a 0–100% predicted overturn probability based on 12 weighted clinical, documentation, and payer factors. Know before you spend time appealing.

Unique to IQAppeals
📋

Documentation Requirement Engine

For each CARC code + payer combination, get the exact documents needed — H&P, LMN, lab results, InterQual criteria — with content requirements and where to obtain them.

238 denial codes
✉️

AI Appeal Letter Generator

Generates payer-specific, submission-ready appeal letters with clinical language, ICD-10 rationale, CPT justification, and regulatory citations in under 60 seconds.

Powered by Claude AI
🏦

Payer Intelligence Database

14 major payers mapped with appeal windows, P2P success rates, preferred submission methods, known quirks, and retro authorization policies. Always know your payer.

14 payers covered

Deadline Tracker & Alerts

Never miss a filing window. Automatic deadline calculation per payer (30, 60, 90, 180 days), email alerts at 14 and 7 days, and urgent flags at 3 days remaining.

Zero missed deadlines
📊

Revenue Recovery Dashboard

Track overturn rate, revenue recovered, cost per appeal, and AR days. See denial trends by payer, department, and coder. Prove ROI to your leadership team.

Real-time KPIs
Live example

This is what your biller sees the moment a denial comes in

Claim CLM-8821 denied by UnitedHealth under CO-50. IQAppeals instantly scores it, lists every document needed, and tells the biller exactly what to do next — in seconds, not hours.


Try it on your denials →
CLM-8821 · CO-50 · UHC ⚠ 3 days left
Medical necessity not established · $8,400 denied · STEMI I21.9
72%
predicted
overturn rate
Overturn probabilityHigh — appeal recommended
Scoring factors
Diagnosis severity (STEMI)
+High
Procedure–DX alignment
+High
LCD / NCD guideline match
+High
Payer overturn history
+High
Documentation completeness
+Med
LMN not submitted
−Med
AI recommendation Upload troponin labs + submit Letter of Medical Necessity → score rises to ~87%. Request peer-to-peer with UHC medical director — STEMI P2P success rate: 91%.
Payer intelligence

Know your payer
before you appeal

Every payer has different rules, windows, and quirks. IQAppeals has them all mapped — so you always know exactly what you're walking into.

UnitedHealth
L1 window60 days
CO-50 overturn75%
P2P success82%
PortalOptum One
Medicare (CMS)
L1 window120 days
CO-50 overturn82%
ALJ overturn72%
Levels5 levels
BCBS
L1 window180 days
CO-50 overturn71%
P2P success65%
PortalAvaility
Aetna / CVS
L1 window180 days
CO-50 overturn63%
P2P success58%
PortalAvaility
View all 14 payers in the platform →
Pricing

One recovered appeal
pays for the whole year

Start free. No credit card. No contract. Cancel anytime.

Starter
Solo Practice
Perfect for independent practices and small billing offices
$299
/month
Up to 100 denials / month
Full CARC/RARC code library
Documentation checklists
Basic AI overturn scoring
Deadline tracker & alerts
1 user · email support
Start free trial →
Enterprise
Hospital / RCM Firm
For health systems, hospitals, and large RCM outsourcing companies
$2,400
/month
Unlimited denials
Full API access + white-label option
Custom ML model training on your data
Unlimited users · SSO/SAML
Dedicated CSM + SLA guarantee
HIPAA BAA · SOC 2 Type II
Talk to sales →
What providers say

Results that speak
for themselves

★★★★★
We recovered $340,000 in our first 90 days. The documentation checklist alone is worth 10x the subscription — our billers finally know exactly what to submit.
★★★★★
The AI overturn probability score changed everything. We now triage our denials in minutes and only spend time on appeals we can actually win. Our overturn rate went from 48% to 71%.
★★★★★
I manage appeals for 12 practices. IQAppeals is the first tool that actually understands payer-specific rules. The UHC P2P guidance alone has saved us from losing dozens of legitimate claims.

Ready to recover what's
rightfully yours?

Start your free trial today. No credit card. No contract.
Your first recovered appeal will pay for the entire year.

Start free — no credit card → Talk to sales
HIPAA compliant · SOC 2 Type II · BAA available · Cancel anytime