Frequently asked questions

No. Appeal Builder is intended only for properly de-identified information. Remove names, dates of birth, member and authorization numbers, record numbers, contact information, addresses, patient-related dates and any other details that could identify the patient before you upload. The built-in screen helps catch obvious mistakes, but it cannot guarantee a document is de-identified.

No. Your browser reads the text from PDF, Word and text files on your own computer. Only the reviewed text you approve is sent for analysis. File names, file properties, comments, images and hidden metadata are not sent.

No. Clinical text, analyses and letters are processed for your session and are not saved in our database. Download your letter before you leave the page; closing the page clears your work. Our database stores only your account, practice, plans and usage counts.

It is instructed never to, and every quoted excerpt is automatically checked against your documents. Quotes that cannot be matched are flagged for your review. The analysis reports contradictions and tells you when the record supports the payer.

No, and it won't guess. You can select your state, plan type and payer type to shape terminology, but Appeal Builder does not calculate deadlines or assert payer policies. Always verify applicable payer, plan, state, and federal appeal requirements before submission.

Only when your appeal letter is successfully generated. Starting an analysis does not count, and re-opening or re-drafting the same appeal does not count again. Plans include 10, 25 or 50 letters per month, and unused letters do not roll over.

Yes. Every plan starts with a 14-day free trial that includes 2 letters. A card is required, but you won't be charged until the trial ends, and you can cancel anytime before then from Account > Manage billing. Stripe emails a reminder before the trial ends. One free trial per practice.

Yes. Letters cost $4.50 each with no subscription or commitment, bought in any quantity up to 20 at a time. Purchased letters never expire. Subscribers can also buy extra letters if they use up their monthly allowance. If you need 7 or more letters a month, a plan is usually cheaper.

Text-based PDF, Word (.docx) and plain text (.txt) files, up to 10 per appeal. Scanned or image-only PDFs, password-protected files and older .doc files can't be read in this version; save a text-based, de-identified copy instead.

The downloaded letter keeps placeholders such as [PATIENT NAME] and [MEMBER ID]. Fill them in on your own approved computer or clinical system after downloading. Never type patient identifiers into Appeal Builder.

The denial letter, a clinical assessment or intake note, and the treatment plan. Anything else that supports the request helps, such as progress notes, assessment scores, behavior data, school or other provider reports, or the original authorization request. You can upload files, paste text, or both.

Yes. Appeal Builder includes a reviewed library of federal rules (for example parity, ERISA appeal rights, Medicaid managed care and EPSDT) and searches official government and payer websites for your state's rules and the payer's own policy. Only the state, plan type, service and payer name are used for that search, never your documents. Every cited source is listed with a link so you can confirm it applies before sending. You can also add the payer's policy or a state regulation yourself (most denial letters offer a free copy of the criteria used); the letter will then show how the record meets each criterion.

Under HIPAA de-identification rules, any date tied to a patient (including service dates) counts as an identifier; the year alone does not. Appeal Builder changes dates to the year automatically. Add the real dates to the letter after you download it.

It is a draft. An appropriately authorized professional must review, correct and approve it before use. Notes marked [Clinician to confirm: ...] point to items the record could not settle.

Appeal Builder is designed so that it should not receive protected health information, which depends on documents being properly de-identified before upload. It does not claim to be exempt from any law, is not legal advice, and does not make coverage determinations.

Use "I may have sent identifying information" on the results screen. Your session's documents are cleared immediately, a minimal incident record is created (without the content), and the owner follows the incident procedure. Also follow your own organization's privacy procedures.

Yes, anytime from Account > Manage billing. Payment details are handled by Stripe; we never see your full card number.