Akeso AI ingests messy chart notes and payer denial faxes to generate citation-grounded appeal dossiers, peer-to-peer battle cards, and real-time patient status updates in under two minutes.
UHC_DENIAL_PT-8812.pdf • 8 pages · DERM_ENCOUNTER.pdf • 14 pages
“Denied: Step therapy required. Patient must fail Adalimumab and Methotrexate before IL-23 approval.”
Ingesting the 14-page chart & synthesizing clinical evidence…
APPEAL_PT-8812_L1.pdf • 6 pages + enclosures
The problem
Specialty denials are won on documentation, not persistence. Most clinics simply run out of hours.
Patients wait 3–6 weeks for life-changing biologics while disease progression worsens and flares escalate.
Prior authorization coordinators spend 15+ hours per week manually parsing 8-page denial letters.
Up to 40% of initial specialty rejections are never appealed due to lack of time and complex step-therapy mandates.
Who we serve
From biologics to bone surgery to pet insurance — each practice gets its own rules, evidence and letter language.
Biologics, infusions and specialty drugs where step therapy and severity denials hit hardest.
Skyrizi, Tremfya, Dupixent
Humira, Rinvoq, Enbrel
Stelara, Entyvio, Skyrizi
Keytruda, Imbruvica, Enhertu
The platform
The Akeso AI Council coordinates specialist engines so a single case moves from denial to signed, sent appeal.
Tracks the 72-hour expedited and 7-day standard payer decision windows and drafts the overdue-decision demand when a payer runs late.
Reads the chart and the payer's own policy, then builds arguments where every claim points back to a source.
Catches the errors that cause denials before you submit — and fixes the ones that already happened.
Protects both the practice and the patient after approval.
Deliver finished dossiers through the channel each payer actually reads.
Launch Akeso from the chart and write the signed dossier back.
How it works
Average end-to-end time: under two minutes per case.
Drag & drop the insurer's denial letter or EOB alongside the patient's clinical encounter notes (PDF or scan).
Akeso isolates CARC/RARC rejection codes, matches tried-and-failed medications, and checks the payer's Clinical Policy Bulletins.
Review the editable, citation-backed appeal letter and download a structured, ready-to-fax PDF packet.
Practice ROI calculator
1 to 15 providers
5 to 60 denials per month
Modeled on 1.4 coordinator hours per manual appeal and an average overturned biologic claim value of $4,200. Directional estimate — not a guarantee of outcome.
Staff hours saved monthly
~64 hours / month
Annual practice revenue protected
$318,000 / year
Akeso AI plan recommendation
Practice Pro Tier ($499/mo)
Security & compliance
Built with compliance officers in the room, not bolted on afterwards.
Direct patient identifiers are stripped locally in the browser before anything is transmitted.
Strict BAAs guarantee clinical text is never retained or used to train third-party models.
AES-256 at rest and TLS 1.3 in transit across every request and stored dossier.
Every extraction, edit and export is logged for clinical governance and compliance review.
Signed HHS-standard BAA before your pilot begins — with expiration reminders, versioned revisions, guarded rollbacks and an exportable compliance ledger built in.
Pricing
Single-provider practice getting denials under control.
Billed monthly, cancel anytime
For 2–5 provider practices with a dedicated PA coordinator.
Billed monthly, cancel anytime
Multi-location clinic groups and management organizations.
Billed monthly, cancel anytime
FAQ
Run your first appeal dossier in the next ten minutes — no integration, no procurement cycle.
