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PrismIQ

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Overturn Denials with Policy-Level Precision

Every month, a biller at a small orthopedic or spine surgery practice gets a remittance back from Anthem Blue Cross and makes a quiet decision: is this worth fighting? PrismIQ answers that question before she picks up the phone — and drafts the appeal before she finishes her coffee.

3 claims analyzed
2 appealable
CLM-2024-1847Appeal Ready

Total Knee Arthroplasty

Anthem Blue Cross

$24,000
Win Prob72%
CLM-2024-1901In Review

Cervical Fusion

UnitedHealthcare

$18,500
Win Prob68%

+ 1 more claim pending analysis

Appeal generated in00:47

How It Works

From denied claim to appeal letter in three simple steps.

01

Connect your ERA/835 feed

Upload denied claims or connect your ERA/835 feed directly. We accept all major clearinghouse formats.

02

PrismIQ analyzes payer policy

Our AI cross-references the denial reason code against current payer policy language and medical necessity criteria.

03

Receive your appeal letter

You receive a policy-cited, ready-to-send appeal letter within 24 hours. No templates — constructed arguments.

Built for orthopedic + spine billing teams
24-hour appeal turnaround
Anthem, UHC, Aetna policy coverage

Request a Pilot

Share a sample of your Anthem denied claims. We'll show you exactly what was recoverable — and return a ready-to-send appeal for your hardest denial within 24 hours.

SOC 2
HIPAA
BAA Ready

Every denial is a story. PrismIQ writes the rebuttal.