Claimlyt
AI that fights insurance claim denials end-to-end — 30–45 minutes of specialist work cut to under 3 minutes per appeal.
- Industry
- Healthcare revenue cycle
- Region
- United States
- Stage
- Flagship venture
- What we built
- Multi-agent AI pipeline + claim-lifecycle dashboard
Figures reflect designed capacity from the build; live production metrics are verified per engagement.
The problem
US insurers deny over $260 billion in healthcare claims annually. Roughly half are never appealed — providers write off the revenue because each appeal takes a specialist 30–45 minutes of research and writing, and most billing teams can't justify the cost.
The solution
A 7-node multi-agent AI pipeline that analyzes each denial, retrieves winning appeal strategies via RAG over medical policy and payer guidelines, plans an evidence-backed argument, drafts the appeal, runs an automated quality check, and finalizes for human review. It submits through email, fax, or direct payer API. A claim-lifecycle dashboard tracks every appeal from denial through resolution.
The pipeline
The outcome
Appeal generation time cut from 30–45 minutes to under 3 minutes per claim, enabling providers to pursue denials previously written off as uneconomic. The business model — a percentage of recovered funds — means providers pay nothing upfront, aligning incentives end-to-end.
Stack
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