Denyify uses AI to automate the creation of customized medical claim appeals, increasing the likelihood of payer approval. Their SaaS platform helps healthcare providers reduce claim denials, minimize staff workload, and improve revenue cycle management.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers face increasing claim denials, leading to delayed revenue, costly appeals processes, and administrative burdens. The industry average denial rate is significant, resulting in billions of dollars in lost revenue annually and consuming valuable staff time. Inefficient claim recovery processes often result in net losses for providers, even after successful appeals.
Solution
Denyify offers an AI-powered SaaS platform that automates the creation of customized medical claim appeals, increasing the likelihood of payer approval and accelerating revenue recovery. The platform leverages GPT LLMs trained on denials data, including owned, sourced, and synthetic data, to generate high-fidelity appeals. By automating the appeal writing process, Denyify reduces the administrative workload for healthcare providers, allowing them to focus on patient care. The platform supports over 30 provider specialties with nuanced, evidence-based reasoning and offers features like custom model embeddings to scale specific appeal styles.
Target Audience
Denyify targets healthcare providers, patient advocates, and revenue cycle management (RCM) professionals seeking to reduce claim denials, minimize administrative workload, and improve revenue cycle management.
Features
- Generative AI appeals engine for high-fidelity appeal writing
- GPT LLMs trained on denials data for informed and sustainable appeals
- Provider-specialty workflows supporting over 30 specialties
- Custom model embeddings to scale voice, style, and successful appeals
- Clinical citations (BETA) providing generative, peer-validated knowledge retrieval
- Agents as a Service (BETA) to offload payer-provider communications
- Integration of provider feedback through a Reinforcement Learning from Human Feedback (RLHF) program
- 60-day credit guarantee, ensuring payment only for successfully appealed denials