Predict denials.
Prevent rework.
Win more appeals.
Ember identifies at-risk claims before submission and automates appeals when denials occur, drafting evidence-based letters, compiling payer-specific packets, and tracking every deadline through to resolution.
Trusted by specialty groups and health systems
Why Ember?
Predictive denial scoring
Pre-bill prediction models score denial probability by reason, payer, and code set.
Root-cause insights
Pinpoint trends in auth, eligibility, coding, or missing documentation.
Appeals automation
Drafts evidence-backed letters and assembles payer-ready packets.
Real-time tracking
Monitor appeals, deadlines, and outcomes with full transparency.
What Ember automates
01
Predict and prevent
Predictive denial scoring and pre-bill edits for coding, modifiers, NCD/LCD criteria, and missing documentation.
02
Appeal creation
First- and second-level appeal letters grounded in payer-policy interpretation, with codes, evidence, and references.
03
Packet assembly
Medical records, visit notes, imaging/labs, auth proofs, itemized bills, and UB-04/1500.
04
Submission and follow-through
Payer portals, e-fax, mail kits, and coordinated phone calls, with reference numbers and receipt tracking.
05
Worklists and SLAs
Queues by reason code, value-at-risk, and timely filing windows.
06
Underpayment and reconsiderations
Flags takebacks and short pays, and generates reconsideration letters.
Meet the agents behind it
Denial prevention and recovery run on Ember's AI orchestration layer, alongside agents for every adjacent workflow.
Denials Management
Predictive denial scoring, clinical reasoning on root cause, and payer-specific appeals with cited evidence.
Explore the agentUnderpayments
Compares every remit against contracts and fee schedules, flags variances, and drives recovery.
Explore the agentAR Follow-Up
Checks claim status in payer portals, resolves holds, and drives outstanding claims to payment.
Explore the agentHow it works
01
Connect to your EHR/PM/data lake
Reviews claims, ERAs, CARC/RARC, and notes.
02
Score risk and apply edits
Predictive denial scoring with clean-claim edits applied pre-bill.
03
Draft an evidence-backed appeal
If denied, the agent drafts the appeal and assembles the packet automatically.
04
Submit, monitor, and escalate
Routes exceptions to staff with full context.
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
Payer-behavior analytics: root-cause trends by payer, specialty, code, and location.
Appeal win-rate tracking, with dollars-at-risk and dollars-recovered.
Full rationale, versioned history, and audit trails for every action.