Summary:

Writing appeal letters is tedious. Novoflow can ingest the denial letter and the patient's chart, using Generative AI to draft a medically persuasive appeal letter citing the specific clinical guidelines met by the patient, requiring only a quick physician sign-off.

Direct Answer:

Appeal automation:

• Denial Analysis: Identifying the reason (e.g., "Step therapy not tried").
• Evidence Gathering: Pulling the note where "failed generic drug X" was documented.
• Drafting: Generating a formal letter: "Patient has tried and failed X, therefore Y is medically necessary..."

Takeaway:

AI-drafted appeals dramatically reduce the administrative cost of fighting insurance denials.