Automate denials management
end-to-end using AI
Ember detects denials the moment remits land, applies clinical reasoning to the root cause, drafts payer-specific appeals with cited clinical evidence, and feeds every determination back into an upstream prevention loop.
Trusted by specialty groups and health systems
Why Ember?
Caught in real time
Denials surface the day the remit lands, not at month-end.
Root cause, not symptoms
Classifies coding, documentation, eligibility, and payer-rule causes.
Evidence-cited appeals
Every appeal cites the policy, criteria, and clinical excerpts that support it.
Prevention built in
An upstream prevention loop: appeal outcomes feed pre-bill scoring so denial rates fall over time.
What the denials management agent does
01
Automate denials management end-to-end using AI
Ember reliably picks up denials from your remittance flow, pulls the relevant clinical documentation from your EHR, and submits complete appeal packages directly into payer portals and mail channels.
02
Draft appeals for any payer format
Ember interprets each payer's policies and appeal requirements, mapping clinical evidence, policy citations, and claim details into the right first- or second-level format — getting smarter with every determination.
03
Human-in-the-loop verification
Appeals go out only after staff review and approval. Overturns, upholds, and payer feedback are logged and analyzed so the same denial doesn't happen twice.
Explore more Ember agents
One orchestration layer, purpose-built agents for every step of the revenue cycle.
Prior Authorizations
Verifies requirements, assembles clinical documentation, and submits to payer portals and ePA systems.
Explore the agentBenefits Verification
Checks coverage, plan details, and patient responsibility across payer portals before the visit.
Explore the agentMR Requests
Validates authorization, retrieves the right records from your EHR, and delivers them securely.
Explore the agentPayment Posting
Matches ERAs to claims, posts payments and adjustments, and reconciles against deposits.
Explore the agentAR Follow-Up
Checks claim status in payer portals, resolves holds, and drives outstanding claims to payment.
Explore the agentUnderpayments
Compares every remit against contracts and fee schedules, flags variances, and drives recovery.
Explore the agentMedical Necessity
Evaluates orders against payer criteria, finds documentation gaps, and assembles clinical evidence.
Explore the agentRevenue Integrity
Validates coding and documentation before claims go out — catching undercoding and denial-prone errors.
Explore the agentDocumentation
Drafts compliant notes, letters, and forms from EHR data, ready for clinician review and sign-off.
Explore the agentHow it works
01
Detect the denial
Monitors remits and payer responses for denials and at-risk claims.
02
Analyze root cause
Determines whether coding, documentation, or payer rules drove it.
03
Draft and submit the appeal
Assembles the payer-specific package with cited evidence.
04
Learn from the outcome
Feeds determinations into the upstream prevention loop and pre-bill scoring.
Numbers from live deployments.
Not projections. Not modeled estimates. Measured customer outcomes.
57%
Fewer denials
3.3x
ROI in month one
100+
FTE hours saved / month
+9.3%
Net revenue per appointment
Built for oversight
Compliance & oversight
Appeal letters with traceable citations to policy and clinical sources.
Versioned history of appeals, determinations, and reviewer sign-offs.
Appeal playbooks configurable by payer, denial type, and dollar threshold.