What is a denial appeals platform?

Software that turns an insurance denial into a complete, evidence-based appeal. Apellica is AI-native: it reads the denial and the payer's policy, drafts the appeal, verifies the citations, and tracks the outcome, so appeals scale without scaling headcount.

Health systems and practices recovering denied revenue, specialty pharmacies protecting fills, and manufacturers funding patient access. Individual patients can use the consumer wizard directly.

How well does it work?

Across 73,987 real external-review outcomes we analyzed, 46.9% of appealed denials were overturned. Every appeal is backed by traceable evidence and the payer's own policy language, not boilerplate.

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Platform

The AI-Native Denial Appeals Platform for Healthcare

Apellica overturns insurance denials at scale. The engine reads the denial and the payer's own policy, drafts a payer-ready appeal, verifies every citation, and tracks the outcome. Across 73,987 real external-review outcomes we analyzed, 46.9% of appealed denials were overturned.

For enterprise teams I'm a patient, start my appeal →

How the platform works

Reads the denial and the policy

The engine parses the denial reason, the clinical record, and the payer's own coverage criteria, then scores each case on its likelihood of being overturned.

Drafts a payer-ready appeal

It assembles a medical-necessity argument grounded in the plan's criteria and the controlling federal rule, with every citation verified before the appeal is finalized.

Verifies and routes

A human review gate is available for sensitive cases. Finished appeals are dispatched through the right channel, and outcomes flow back into reporting.

Reports and improves

Every appeal is traceable: what was argued, why, and with what result, so the program sharpens with each cycle.

Bring us your denials

Health systems, pharmacies, and manufacturers: see where your recoverable revenue and stalled therapy starts are hiding. A partnership consultation takes about 30 minutes.

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Frequently asked questions

What is a denial appeals platform?: Software that turns an insurance denial into a complete, evidence-based appeal. Apellica is AI-native: it reads the denial and the payer's policy, drafts the appeal, verifies the citations, and tracks the outcome, so appeals scale without scaling headcount.
Who is it for?: Health systems and practices recovering denied revenue, specialty pharmacies protecting fills, and manufacturers funding patient access. Individual patients can use the consumer wizard directly.
How well does it work?: Across 73,987 real external-review outcomes we analyzed, 46.9% of appealed denials were overturned. Every appeal is backed by traceable evidence and the payer's own policy language, not boilerplate.