Three agents. One rule: the human decides.
Appelo prepares the paperwork end-to-end — then hands every output to your team for review and approval. Here's what each agent actually does.
Reads the denial. Drafts the winning appeal.
Appelo classifies the denial reason, pulls the supporting documentation from the chart, and drafts a payer-specific appeal that cites the exact medical-necessity criteria — ready for your review.
- Classifies the denial code and root cause
- Pulls conservative-care notes, imaging, and op reports from the chart
- Cites the right payer policy / LCD for medical necessity
- Drafts the letter — you edit, approve, and submit
Catches the gaps that cause denials — before you submit.
Prevention beats recovery. Appelo scans each claim or prior-auth packet against payer requirements and flags what's missing, with a suggested fix your team accepts or dismisses.
- Flags missing conservative-care documentation
- Detects CPT / ICD-10 code mismatches
- Catches payer-form and modifier issues
- Suggests the fix — your team accepts or dismisses
Assembles the packet. Tracks it. Preps the peer-to-peer.
Appelo builds each prior-auth packet against the payer's checklist, tracks submission status, and — when a peer-to-peer is needed — preps a clinical summary and talking points for your physician.
- Builds the packet against each payer’s requirement checklist
- Tracks submission and approval status in one place
- Preps a peer-to-peer pack: clinical summary + talking points
- Your team confirms and submits
3-point clinical summary + medical-necessity talking points ready for Dr. review.
Every workflow ends with your approval.
That's the whole point. See it on your own denials.