Clausea | AI Denial Appeal Automation

They win by making you
do busywork.

Insurers have created an information asymmetry. They use bots to reject you instantly. They force you to use fax machines and manual letters to respond.

It's designed to be so annoying that you just give up.

The Logic Trap: Denials are pattern mismatches. They automate the rejection; you perform manual labor to fix it.
The Fatigue Factor: Writing a custom appeal takes 45 minutes. If the claim is under $150, you write it off.
The Timely Filing Trap: While you're buried in manual work, the clock runs out. Denied claims become dead claims.

Average denial rate across US practices

Cost to rework one denial manually

Of denied claims never get appealed

0M+

Policy pages indexed in our engine

The Science

Weaponize their own policies.

1. Upload the Denial

Drop your denial letter PDF, JPG, even a blurry fax scan. No EHR integration. No IT department. Just drop it.

2. We Find the Clause

Our engine pulls the current policy bulletin for that payer and locates the exact clause that validates your claim. Not a template the actual policy text.

3. Sign and Submit

Your appeal letter arrives ready to send legally cited, payer-specific, formatted for submission. You sign. You fax. You get paid.

Real Wins

CO-50 · UHC · $1,185

"We had 34 UHC denials in our dead pile. Clausea worked through all of them in one afternoon. Recovered $38,400 in two weeks."

Sarah M.

RCM Manager · Dallas, TX

PR-1 · Aetna · $892

"I used to spend 45 minutes per appeal letter. Now it's under 2 minutes. That's 8 hours a week back. I can't imagine going back to manual."

James R.

Solo Biller · Nashville, TN

CO-177 · BCBS · $2,340

"We manage 23 practices. Clausea's batch upload means one person handles what used to take three. Our overturn rate went from 31% to 67%."

Angela T.

Billing Company Owner · Houston, TX

Recent recoveries

CO-50 · UHC · $1,185 CO-177 · Aetna · $3,200 PR-1 · BCBS · $780 CO-45 · Cigna · $2,100 PR-96 · Medicare · $445 CO-4 · UHC · $1,890 CO-22 · Humana · $670 CO-50 · Aetna · $992 CO-177 · BCBS · $2,340 CO-50 · UHC · $1,185 CO-177 · Aetna · $3,200 PR-1 · BCBS · $780 CO-45 · Cigna · $2,100 PR-96 · Medicare · $445 CO-4 · UHC · $1,890 CO-22 · Humana · $670 CO-50 · Aetna · $992 CO-177 · BCBS · $2,340

For Billing Companies

One account.
Every practice
you manage.

Medical billing companies use Clausea to process denials across all their practices in one place. Batch upload a ZIP of 50 EOBs, get 50 appeal letters. One tool. One workflow. Massive leverage.

Batch processing

Upload a ZIP of 50 denials. We categorize by payer and denial code, then generate every appeal letter.
Multi-practice dashboard

Track denial rates, recovery totals, and appeal status across all your practices in one view.
White-label option

Your logo. Your branding. Clausea's engine underneath. Add it as a premium service to your existing clients.

Talk to us about billing companies

Practice recovery breakdown

Practice A · Orthopedics$12,400/mo

Practice B · Primary Care$8,200/mo

Practice C · Dermatology$6,800/mo

Practice D · Cardiology$19,100/mo

Practice E · Pediatrics$3,900/mo

Total recovered (5 practices) $50,400/mo

Our Edge

We've seen your denial before.

Every appeal we generate teaches us what works. CO-177 on CPT 99213 from Aetna? We've processed hundreds of identical denials. We know the exact clause that overturns it.

Payer · Code · CPT

847 wins

Aetna · CO-177 · 99213

Contractual adjustment denial on E&M level 3. Winning argument: modifier documentation per Aetna Clinical Policy Bulletin 0131, Section IV.

91% overturn

Payer · Code · CPT

1,203 wins

UHC · CO-50 · 99213

Medical necessity denial. Winning argument: UHC Coverage Determination Guideline CDG.024.09 documented HCC risk stratification.

87% overturn

Payer · Code · CPT

562 wins

BCBS · CO-4 · 99215

Service not covered denial on complex E&M. Winning argument: BCBS BlueCard PPO Medical Policy S-155, coverage applicable under comorbidity criteria.

78% overturn

Growing every day

150M+

policy pages indexed across all major US payers

Waystar serves hospitals. Aspirion uses attorneys. We do something different: we index the exact clause that overturns your exact denial code with your exact payer and we verify it with real appeal outcomes. That database is ours alone.

Features

EOB Table Parsing

Handle massive Explanation of Benefits tables. We extract line items, remark codes, and adjustments instantly.

Messy Scans? Fine.

PDFs, JPEGs, low-quality fax scans. If a human can read it, our AI can read it and argue from it.

Universal Payer Index

UHC, Aetna, Cigna, BCBS, Medicare, Medicaid and hundreds more. All 50 states. Every major payer covered.

Legal Argument Engine

We don't summarize. We argue. The AI constructs logical proofs using the payer's own policy language against them.

Automatic Batching

Upload a ZIP of 50 denials. We rotate, sort, and categorize them by payer and denial code. One upload. 50 appeals.

+ Many more features

Everything you need to turn your dead pile into recovered revenue.

Free Dead Pile Audit

How much is sitting in your dead pile?

Tell us your monthly denial volume and top payers. We'll calculate your estimated recoverable revenue in 30 seconds. No patient data. No commitment.

Monthly denied claims

Average claim value

Your top payer

Work Email Address

Or book a 15-min call to run this with your actual data →

Stop leaving money on the table.

Give us your dead pile from last month. If we don't help you generate a valid appeal, you don't pay.

Starter

$99/mo

One recovered claim pays for the month.

100 appeals / month
All major payers
PDF + fax-ready output
14-day free trial

Try Demo First

They win by making youdo busywork.

Weaponize their own policies.

1. Upload the Denial

2. We Find the Clause

3. Sign and Submit

One account.Every practiceyou manage.

We've seen your denial before.

EOB Table Parsing

Messy Scans? Fine.

Universal Payer Index

Legal Argument Engine

Automatic Batching

+ Many more features

Safe and secure

How much is sitting in your dead pile?

Stop leaving money on the table.

They win by making you
do busywork.

One account.
Every practice
you manage.