We use AI-powered legal precision to reverse medical necessity denials for Physical Therapists, Chiropractors, and Surgical providers in California. 100% HIPAA-compliant. Zero PHI exposure.
No commitment. No credit card. One free appeal, yours to keep.
Insurers deny PT saying "patient reached plateau." We use the Jimmo Standard to prove skilled maintenance is medically necessary — no improvement required.
UHC, Aetna, and Cigna use algorithms to auto-deny. We leverage CA HSC § 1367.01(k)(2) — the 2025 AI prohibition law — to challenge their legality head-on.
Stop wasting 2 hours per appeal. Our AI drafts legal-grade letters in seconds with deeper statutory depth than manual writing.
Built by compliance experts for healthcare providers who are tired of losing revenue to automated denials.
Every letter cites federal ERISA regs (29 CFR § 2560.503-1), California HSC § 1367.01, § 1374.30 (IMR), and relevant case law — Wit v. United Behavioral Health, Egan v. Mutual of Omaha.
Tailored for Physical Therapists, Chiropractors, and Spine Surgeons. Includes clinical evidence tables, objective deficit documentation, and fall-risk arguments.
We embed a formal Peer-to-Peer Review Request in every letter. Insurance medical directors often approve rather than take the 30-minute call.
Industry-standard appeal letters cost $250–$500. We're 40% below market — built for volume, not markup.
Your first appeal is completely free. No credit card. No strings. See what legal-grade looks like before you commit.
We never handle Protected Health Information (PHI). Our workflow requires all documents to be redacted (masked) before processing. You maintain full control; we provide the precision.
Redact name, SSN, DOB from all documents. We never see PHI — zero exposure.
Submit the denial letter and clinical notes summary through our secure portal.
Get a high-authority, legal-grade appeal draft ready for your signature within 24 hours.
California Health & Safety Code § 1367.01(k)(2)
The 2025 AI Prohibition — insurance algorithms cannot deny medical necessity. Physician review required.
ERISA 29 CFR § 2560.503-1
Federal claim procedure — 7 mandatory elements for any valid denial notice.
DMHC Independent Medical Review (IMR) — CA HSC § 1374.30
Binding external review paid by the insurer. We include the IMR trigger in every Professional+ appeal.
Wit v. United Behavioral Health (N.D. Cal. 2019)
Landmark case — 60,000+ claims ordered reprocessed for improper medical necessity criteria.
Peer-to-Peer Review Request + Objective Clinical Data Table
Forces insurer to engage a physician, not an algorithm. Includes muscle strength, SLR, gait deficit table.
Send us your details and we'll respond within 2 hours with your free appeal draft process.