Aegis is an all-in-one AI platform designed to help healthcare providers, hospitals, and medical billing teams recover lost revenue by automating the complex and time-consuming process of insurance denial appeals. The platform leverages intelligent AI agents to manage the entire appeals workflow, from denial detection to final resolution.
Key Capabilities and Benefits
Historically, healthcare providers lose over $260 billion annually to denied claims, and due to the manual nature of the process, fewer than 15% of denials are appealed, even though over 50% of appeals are successful. Aegis addresses this gap by providing an AI-first infrastructure to fight back against the rise of AI-driven denials from payers.
- Intelligent Denial Prioritization: Aegis continuously monitors claims data and instantly flags denied claims, ranking them by financial impact and the likelihood of a successful overturn. This allows billing teams to focus their efforts on the highest-value opportunities.
- Policy-Aware Appeal Generation: The system pulls necessary data from Explanation of Benefits (EOBs), patient files, and integrated Electronic Health Records (EHRs) to automatically generate precise, policy-specific, and compliant appeal letters.
- One-Click Submission: Appeal packages, including the AI-drafted letter and supporting documentation, are assembled and submitted directly to the insurance provider via the appropriate channel (fax, payer portal, or clearinghouse).
- Deep Denial & Revenue Analytics: The platform provides end-to-end tracking of every appeal and surfaces valuable insights into denial patterns by payer, procedure, provider, and code. This helps organizations take proactive steps to reduce future denial rates and create a self-healing revenue cycle.
By automating the process, Aegis claims to achieve a 90% faster appeal submission time and a 90% lower cost per appeal, allowing providers to submit up to 4x more appeals.
