Medical Coding

← Home/Denial Engine · v1

From a denied claim to a correction and an appeal letter.

Paste an EOB excerpt or denial letter. Three sequential model calls produce a structured denial analysis, a proposed corrected claim, and a payer-ready appeal packet — all grounded in the original denial text and claim context.

Synthetic samples only — no PHI. The production architecture for handling real payer correspondence is described on the architecture page.

EOB excerpt or denial letter. Synthetic only — no PHI.
CPT / ICD / DOS — the original claim the correction step works from.

Step 1 will call /api/denial/analyze.

1. Analysis

No analysis yet. Click Analyze denial.

2. Correction

No correction yet. Run the analysis first.

3. Appeal packet

No appeal yet. Generate the correction first.

Honest limitations

No live payer integration

Nothing is submitted anywhere. The appeal packet is generated for inspection, not transmission.

Synthetic denials only

Sample EOB excerpts and claim contexts were written for this demo. No real payer correspondence and no PHI is processed.

Not legal, billing, or coding advice

Output needs a certified coder and the payer-specific policy in front of them before any production claim is corrected or appealed.

No catalog validation in v1

Suggested CPT and ICD-10 codes are not validated against current AMA/CMS catalogs here — that's the next deterministic layer, mirroring the E/M demo's NCCI table.

Three single-shot calls, no agent loop

Each step is one Gemini call with the prior step's result as input. No retry, no critic pass, no tool use. Deliberate simplicity for v1.

HIPAA-aware, not HIPAA-compliant

This route calls Google AI Studio without a BAA. Production deployment requires Vertex AI under BAA — see the architecture page.