Win 85% of Your Appeals — On Autopilot
AI-generated appeal letters that cite clinical evidence, payer policies, and regulatory guidelines automatically. Stop losing winnable cases.
Average appeal success rate
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Your Team Can’t Appeal Every Denial — And Payers Know It
Payers design their denial processes knowing most practices lack the bandwidth to respond. Manual appeals aren’t a strategy — they’re a losing battle.
2–4 hrs
Time to write one appeal manually
Billing teams spend hours researching policies, writing letters, and gathering supporting docs — for every single denial.
37%
Average appeal rate at most practices
Over half of appealable denials go unchallenged because teams don't have bandwidth. Payers count on this.
$260B
Left on table annually
A 200-physician group leaving 63% of denials unappealed loses $2–4M per year in recoverable revenue.
Everything Required to Win at Scale
From letter generation to outcome tracking — NexaClaim automates the full appeal lifecycle.
Streaming Letter Generation
Watch your appeal letter write itself in real-time. AI streams every sentence, citing clinical evidence, LCD/NCD references, and payer-specific policies as it goes.
< 8 min/letter
Clinical Evidence Mapping
AI reads your clinical notes and automatically maps supporting evidence to the denial reason. No manual research required.
Auto-extracted
Regulatory Citation Engine
Every appeal includes relevant CMS guidelines, Medicare LCDs, NCCI edits, and AMA coding guidance — cited with actual policy numbers.
200+ sources
One-Click PDF Export
Generate a professionally formatted, court-ready PDF appeal letter in one click. Includes your practice letterhead and signature block.
< 30 sec
Payer-Specific Templates
Pre-built argument templates for 50+ major payers. NexaClaim knows what United Healthcare responds to vs. Aetna vs. BCBS.
50+ payers
Outcome Tracking
Every appeal tracked to resolution. Know which arguments win by payer, denial type, and CPT code — and automatically improve future letters.
Real-time
Denial Pattern Recognition
AI detects patterns across your denials and identifies systemic coding or documentation issues before they create more denials.
Proactive
Bulk Appeal Generation
Process 50 similar denials at once. AI tailors each letter individually while applying the same winning argument framework.
50x faster
How It Works
From denial to winning appeal in four steps — most completed in under 10 minutes.
Denial Received
A denial hits your system via EDI 835 or manual entry. NexaClaim immediately classifies the CARC/RARC code and pulls all relevant claim data.
AI Analyzes & Researches
Within seconds, AI cross-references the denial against payer policies, CMS guidelines, clinical documentation, and your historical win data.
Letter Generated
A complete, personalized appeal letter streams to your screen with clinical evidence mapped, citations included, and payer-specific arguments applied.
Submit & Track
Export as PDF, submit via portal or fax, and track status in real-time. Win rates and recovered amounts update automatically.
Real Practices. Measurable Revenue Recovery.
From cardiology practices to regional health systems, NexaClaim turns written-off denials into recovered revenue.
Challenge
Writing 200+ appeals/month manually, 34% win rate, 2 FTEs dedicated to appeals.
Result
81% win rate, $4.7M recovered in 6 months, 0.5 FTE now handles appeals.
247% ROI in first 90 days
Challenge
United Healthcare denying 12% of procedures; team couldn't keep up with volume.
Result
Reduced effective denial rate to 3.2%, recovered $1.8M in medical necessity appeals.
$1.8M recovered in year 1
Challenge
Prior auth denials being written off — team said "not worth fighting Anthem."
Result
62% of previously written-off prior auth denials successfully appealed.
62% win rate on written-offs
Average appeal success rate
Average time per appeal letter
Average first-year recovery
ROI within 90 days
Works With Your Existing Workflow
NexaClaim connects to your EHR, practice management system, and clearinghouse in days — no rip-and-replace required.
Frequently Asked Questions
Everything you need to know about NexaClaim’s appeal automation.
Stop Leaving Revenue on the Table
Join 50+ physician groups who have recovered millions in denied revenue with NexaClaim AI. Get started in 15 minutes with a free denial audit.
No credit card required. See results in under 24 hours.