What we heard: denials are a paperwork problem, not a clinical one
We interviewed biologic coordinators, PA specialists, pharmacy access managers, and payer-side experts. The same conclusion kept surfacing: the cases that get denied were rarely wrong on the medicine — they were incomplete on the paperwork. So we do that work for you — starting with the denials you have already lost.
Who we are
Two people, and you can see both of them
We are asking for access to your payer portals and, eventually, your patients' records. You should know exactly who is on the other end of that.
MD Faiz Jamal
Product, engineering and clinical policy
Owns the product, the codebase and the payer-policy corpus — which means he owns whether a criterion we cite is actually what the insurer wrote. Every policy was read against the payer's own published document, and an automated check flags any that has gone too long without re-verification.
MD Kaif Alam
Go-to-market, operations and partnerships
Owns the customer side: outreach, pilots, partnerships and how the work actually gets delivered day to day. If you are working with us, this is usually who you are talking to.
We learned American payer policy the only way that counts here — building the corpus ourselves, one published source document at a time, and checking every criterion against what the insurer actually wrote rather than what a model remembered.
That is also why the work is split the way it is: one of us is accountable for whether the criteria are right, the other for whether you are actually being served. There is no support tier between you and either of them.
What we have built, and what we have notWhat we found
The denials rhyme
Across payers and drugs, denials cluster around a handful of avoidable gaps — which is why an appeal so often succeeds, and why the next case can be built to avoid them.
- Most denials are predictable.
- They come from missing documentation, missing labs or imaging, and missing prior-therapy evidence.
- From incorrect diagnosis coding and unmet step-therapy requirements.
- From a lack of payer-specific knowledge that takes new coordinators months to build.
Positioning
We sell finished work, not software
We are deliberately not trying to be everything. We do one thing: we win back denials, and then we stop the next one.
What we're not
- Software your team has to learn, log into, or find time to evaluate
- Another prior authorization portal
- A generic healthcare AI assistant
What we are
- A service: we do the appeal work and hand back finished output
- Grounded in each payer's own published policy criteria
- Paid only when a denial is overturned
- Built around how access teams actually work
Direction
Deeper before wider
We would rather be the people who reliably win one kind of case than a platform that does a little of everything.
Denials first
The appeals already sitting in your queue, where the money is and where almost nobody is competing.
The authorizations before them
Once we know what your payers enforce, we prepare the next submission to meet it. Bundled — never a separate line.
More payers and drugs
Coverage grows because a real customer needs it, not because it looks good on a page. Adding one is verified content work.
A platform you log into
We tried selling software and it didn't work. If customers ever pull us there we'll listen, but it is not what we are building toward.
Start with five denials you've already closed
Send five denied specialty cases, de-identified. We'll tell you which we judge were winnable and draft the appeal for the strongest. Free.