82% of appeals succeed1—why do physicians fight only 12% of denials?
1 Medicare Advantage 2023 data. Source: KFF (Jan 28, 2025)
Prior authorization denials are a constant challenge across Medicare, Medicaid, and commercial plans — creating more work, more delays, and more frustration for providers. Handling them efficiently is essential to protect revenue and keep care moving.
Most practices leave millions on the table by not appealing denial decisions. We help practices like yours understand, prioritize and appeal denied prior authorizations - all without any upfront investment.
AI-powered denial handling made fast and stress-free
Upload a prior authorization denial letter to our secure platform in any format - PDF, fax or even a screenshot.
Our app reads the letter, checks each reason against the patient's record, and creates an appeal strategy.
Get an appeal letter addressing each denial reason, to submit or for a P2P call.
No EHR integration or setup required
Estimate monthly recovered revenue and submission fees.
Assumptions: 20% appealable, 30 minutes per submission at $25/hr, 50% success of submissions.
Note: labor fee uses 30 minutes per submission at $25/hr ($12.50 per submission). Results are estimates.
Includes 45 appeal letters per month. Additional letters: $0.45 each
Includes 25 verifications per month. Additional verifications: $0.4 each
Access thousands of payer criteria in our growing knowledgebase
Challenge: Prior auth denials hurt revenue and patient care
Solution: Turn denied cases into revenue with our risk-free service
Reduce appeal prep time by 77%
Increase approval rate by 30%
Recover revenue with $0 upfront cost
Challenge: High appeal costs reduce profitability and client satisfaction
Solution: Improve client outcomes while reducing operational costs
Reduce denial rates for clients
Lower appeal processing costs
Improve customer satisfaction scores
A “win” means your prior authorization denial is overturned and you receive pre-service approval for the service. Notably, payers may still reject claims even after prior authorization is granted.
We prepare a detailed appeal letter and supporting documentation for your peer-to-peer (P2P) call, making it easy for your provider to present the strongest case to the payer.
No integration is needed. CoveredOrNot works as a secure, web-based platform that fits into your existing workflow—no EHR setup or IT support required. You can import the patient data in many ways: PDF, scanned images or even screenshots from the EHR.
Yes, we sign Business Associate Agreements (BAAs) to ensure HIPAA compliance. View our BAA.
Your data security is our top priority. CoveredOrNot implements enterprise-grade security measures to protect your patients' health information.
End-to-end encryption for all data in transit and at rest using AES-256 encryption standards.
Hosted on Microsoft Azure in the United States with HIPAA-compliant infrastructure and data centers.
SSO integration and business email verification ensure only authorized users access your data.
We sign BAAs with all customers to ensure full HIPAA compliance. Download our BAA.
24/7 monitoring with established breach response procedures and notification protocols.
All patient data remains within US borders and is never transferred internationally.
Join healthcare providers who are reclaiming millions in denied revenue
✓ Zero upfront cost ✓ Increased approval rate ✓ You only pay when we win
CoveredOrNot is a US-based company on a mission to help patients and providers understand and streamline prior authorization. We believe in transparency, efficiency, and empowering healthcare professionals with the right information at the right time.