DenialOS

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DenialOS is healthcare revenue cycle management software that unifies eligibility verification, financial clearance, denial management, appeals, payer intelligence, and revenue recovery in a HIPAA-aligned workspace. The platform integrates with EHR systems like Epic and Oracle Health through FHIR R4 connections for real-time data exchange. AI governance ensures all AI-assisted actions, including classification and appeal drafting, are logged and auditable. The system processes denials from formats such as 835 remittance advice and HL7, pre-classifying them and matching them to cases. Appeal drafting synthesizes payer rules, clinical policies, and denial facts. Human approval is required before submission. Dashboards provide revenue exposure insights and simulate appeal strategies. Payer intelligence tracks denial trends and policy changes. Audit trails link communications to case records. The platform includes tenant isolation, role-based access, and PHI-safe alerts.