Appeals that read like your best biller wrote them.
RecoupOps synthesizes clinical chart notes, local coverage determinations (LCDs), and payer policy bulletins into comprehensive, multi-page appeal packages ready for 1-click review.
What goes into a RecoupOps appeal package.
Generic 1-paragraph dispute letters get rubber-stamp denials. RecoupOps compiles structured, legally cited clinical briefs that payer medical directors actually overturn.
Formal Dispute Header
Payer-specific routing addresses, claim IDs, subscriber group numbers, date of service, and clear declaration of appeal level (Reconsideration vs Level 1 Grievance).
Clinical Rebuttal & LCD Citations
Precise clinical justifications citing Medicare Local Coverage Determinations (LCDs), Milliman Care Guidelines (MCG), or commercial Clinical Policy Bulletins.
Indexed Chart Evidence
Automatic extraction of surgeon operative dictations, diagnostic lab reports, and chronological failed conservative therapy logs bound as numbered exhibits.
Zero-Hallucination & Medical Integrity Controls
Provider concerns regarding AI in claims center on accuracy and whether models comprehend payer-specific rules (Experian Health 2025). RecoupOps enforces strict deterministic quality guardrails.
Letters only cite facts present in the verified EHR chart notes. Never hallucinates medical encounters.
Cross-references active 2026 payer coverage rules, LCDs, and NCCI edit manuals.
Every generated appeal is presented in an intuitive review workbench before dispatch.
Deterministic event logging records every edit, approval, and submission timestamp.
See what your denials are actually worth.
Send us one month of 835 remittances under a signed BAA. We'll show you exactly how many dollars are recoverable — before you pay anything.