Healthcare providers spend significant time and resources appealing denied medical claims, costing the industry billions annually. The complexity of the appeals process and the increasing use of machine-driven algorithms by health plans to deny claims exacerbate this issue.

Covered automates the medical claim appeal process for healthcare providers using AI algorithms. The software analyzes previously denied claims and their appeal outcomes to recommend optimal next steps. This approach aims to reduce the time and resources providers spend on reversing incorrect denials, allowing them to focus on patient care and other critical tasks. Covered offers both a denial management product for in-house teams and a full-service solution.

AI-powered analysis of denied claims and appeal outcomes

Recommendation of optimal next steps in the appeals process

Denial management product for in-house teams

Full-service solution for complete outsourcing of the appeals process

Pay-per-success model, ensuring payment only for successfully overturned denials

Covered's primary customers are healthcare providers and provider organizations seeking to streamline their medical claim appeal process and reduce associated costs.

Covered operates on a pay-per-success model, receiving payment only when a denied claim is successfully overturned. Consulting services are also offered to select clients.