Revenue Cycle Management

Denied claims have deadlines.
Most teams miss them.

Collector AI is denial management software for hospital revenue cycle teams. Track every denial, draft every appeal, and catch underpayments before the timely-filing window closes.

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0%
Average initial denial rate across payers, all claim types
SOURCE: CAQH INDEX 2023
$0B
In claims denied annually across U.S. healthcare
SOURCE: AHA / KFF ANALYSIS 2023
0%
Of denied claims are never reworked — written off as bad debt
SOURCE: MGMA / HFMA BENCHMARKS
The problem

Payers have a process for denials.
Most providers don't.

A denied claim doesn't mean you won't get paid. It means you have 90 to 180 days to appeal before the right to appeal expires. Most billing teams don't have a system for tracking that clock.

What happens after a denial

When a payer sends a denial, it includes a CARC code — a machine-readable reason (CARC 197 means "no prior authorization"; CARC 45 means "charge exceeds fee schedule"). That code tells you exactly what to fix and where to appeal.

The issue isn't information. It's capacity. Revenue cycle teams are tracking denials in spreadsheets, drafting appeal letters from scratch, and manually reconciling 835 remittance files against contracted rates.

The payer's appeal window doesn't wait for bandwidth. Timely filing deadlines range from 90 days (many commercial payers) to 180 days. Miss that window, and the write-off is permanent.

Days until appeal deadline — active denials
UnitedHealthcare
12 days
BCBS Illinois
34 days
Cigna
45 days
Humana
67 days
Aetna
81 days
Critical (<21 days)
Urgent (21–60 days)
On track
The product

Every denial, every CARC code,
every deadline — in one place

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app.collectorai.net / claims
Claim # Payer CPT Billed Denied CARC Status Appeal due
CLM24000 UnitedHealthcare 27447 $8,434 $8,434 197 Denied Nov 19
CLM24001 BCBS Illinois 33533 $10,598 $10,598 16 Appeal draft Dec 11
CLM24002 Humana 93458 $5,603 $5,603 4 Appealed Jan 14
CLM24003 UnitedHealthcare 27130 $8,073 $1,129 short 45 Underpaid Feb 03
CLM24004 Aetna 47562 $4,293 Recovered 22 Won —

AI-drafted appeal letters

Collector AI reads the CARC and RARC codes on a denied claim and drafts a payer-specific appeal letter with clinical justification language. Your staff reviews and submits — it doesn't replace clinical judgment, it removes the blank page.

CARC/RARC-aware · Payer-specific language · PHI stripped

835 remittance reconciliation

Ingest Electronic Remittance Advice files and automatically compare paid amounts to your contracted rates. Underpayments of any size are flagged — including the $200 line-item variances that never get caught manually.

Contracted rate comparison · Payer × CPT matrix · Variance thresholds

Prior authorization tracking

CARC 197 — "no prior authorization" — is one of the most common and most preventable denial codes. Collector AI tracks pending, approved, and expiring prior auths so denials from missing authorizations stop happening.

Auth expiration alerts · Payer × CPT coverage · Decision timeline

Payer policy library

Know the coverage rules before you submit and before you appeal. Policy documents are indexed and searchable by payer, CPT code, and diagnosis — so your team can find the specific LCD or coverage determination that supports a claim.

LCD/NCD indexed · CPT × payer lookup · Semantic search
How it works

From remittance file to recovered revenue

No complex implementation. No RPA bots. Connect your clearinghouse, and your denial workflow is running the same day.

01

Connect your clearinghouse

Collector AI ingests 837 and 835 files directly from Availity or any ANSI X12 source. Claims and remittances appear in your dashboard automatically — no manual upload.

02

Denials are triaged automatically

Every denial is classified by CARC code, payer, and days remaining on the appeal window. High-value, expiring-soon denials surface at the top. Your team works the right claims first.

03

Track outcomes, improve patterns

Every appeal outcome is recorded. Over time, Collector AI shows you which denial reasons you win most often, which payers are systematically underpaying, and where your authorization gaps are.

HIPAA-compliant · BAA available
AES-256 encryption at rest
SOC 2 preparation in progress
Full audit trail · 6-year retention
Deployed on AWS · us-east-1
Early access

Ready to work every denial

Collector AI is in early access. Request a demo and we'll reach out within one business day.

No PHI in this form. We'll contact you to schedule a demo.