Denials management, without writing off the money
Takes refused claims, groups them by reason and prepares the appeal
Refused money stops going unrecovered simply for want of time
A refusal is overturned on appeal surprisingly often. The trouble is each appeal costs time, so the small ones get abandoned one by one.
What you get
No refusal slips through
Every refusal enters a work queue, not a report nobody opens.
Grouped by reason
Twenty refusals sharing one cause are dealt with once, not twenty times.
The appeal arrives prepared
The needed documents are gathered from the file automatically; a person checks and sends.
The cause gets removed
What is refused repeatedly points to a problem upstream. You see it in numbers, so you can fix it.
How it works
1. Collecting refusals
Refusals are read from the insurer's report, whatever format it arrives in.
- OCR
- n8n
2. The reason
The refusal code or wording is normalised into a reason comparable across insurers.
- GPT-4.1
3. Prioritisation
Amount, appeal deadline and historical success rate decide what gets worked first.
- PostgreSQL
4. The appeal file
The documents that reason requires are gathered from the patient file, ready to check.
- PostgreSQL
5. Deadlines
Each appeal has a tracked deadline. Nothing expires because it was forgotten.
- n8n
Results
A 70-employee catering group with two event venues
Automatic grouping by cause and deadline tracking already runs in production, in another sector.
- Automation workflows
- 125 63
- WhatsApp errors per hour
- 15–30 0
- Security findings
- 584 383
- Weeks to production
- — 6
Works with what you already run
- n8n
- PostgreSQL
Related solutions
Frequently asked questions
- Do you hold security certifications?
- We hold no ISO 27001 or SOC 2, and we imply nothing to the contrary. If you need them, tell us early and we will recommend somebody else.
- Does the system send appeals by itself?
- No. It prepares them; a person confirms the send. A wrong appeal burns a deadline you do not get back.
- Is it worth it for small amounts?
- That is exactly where it shows. Large amounts get appealed anyway; small ones get abandoned, and in aggregate they are usually the larger number.
- We have no structured report from the insurer.
- You do not need one. We read what arrives — PDF, spreadsheet or email — and do the structuring.
- How long does it take to set up?
- Three to six weeks. Most of the time goes on mapping refusal reasons, not on building.