Open Appeals
247
↑ 18 this week
Overturn Rate (MTD)
68%
↑ 4% vs last month
Revenue Recovered
$312K
↑ $41K vs last month
Avg Days to Decision
22d
↓ 3d vs last month
Denial Reasons — Overturn Probability View all →
| Code | Reason | Probability | Action |
|---|
Denials by Payer (This Month)
Priority Workqueue View all 247 →
| Claim | Payer | Code | AI Score | Deadline |
|---|
Upcoming Deadlines
Overturn Rate by Appeal Level
Top Denial Categories
Monthly Revenue Recovered
Denial Workqueue
| Claim ID | Patient | Payer | Code | Billed $ | AI Score | Deadline | Status | Action |
|---|
← Workqueue
Denial Detail — CLM-8821
Urgent — 3 days
CO-50
Claim ID
CLM-8821
Payer
UnitedHealth
Patient
J. Martinez
Service Date
Apr 2, 2026
Billed
$8,400
Denied
$8,400
Denial Reason — CARC CO-50
Medical necessity not established
Procedure: 99285 (ED E&M L5) · DX: I21.9 (STEMI) · Memorial Hospital ED
Required Documentation 5 of 8 collected
AI Overturn Probability
72%
overturn
AI Recommendation
Upload troponin labs + submit LMN → score rises to 87%. Request peer-to-peer with UHC medical director — STEMI P2P success rate: 91%.
Appeal Timeline
Similar Appeals — Historical Outcomes
| Payer | Code | Amount | Result | Key Docs |
|---|---|---|---|---|
| UHC | CO-50 | $7,200 | Overturned | LMN + labs |
| UHC | CO-50 | $9,100 | Overturned | P2P + LMN |
| UHC | CO-50 | $6,800 | Upheld | No LMN |
| UHC | CO-50 | $11,400 | Overturned | All 8 docs |
UHC CO-50 overturn rate: 75% · Industry avg: 61%
AI Scoring Engine
v2.4 · XGBoost + Rules
Weighted Factor Simulator — adjust sliders to see live score changes
Predicted Overturn Probability
72%
High — appeal recommended
Confidence
64–79%
Est. Recovery
$6,048
Decision
Appeal
Scoring Formula
// Logistic regression + XGBoost ensemble
P(overturn) = σ(Σ wi · fi + b)
// Factor groups
Clinical = f(dx, proc, lcd, hcc) [45%]
Docs = f(complete, lmn, timely) [30%]
Payer = f(history, level, auth) [25%]
σ(x) = 1 / (1 + e-x)
P(overturn) = σ(Σ wi · fi + b)
// Factor groups
Clinical = f(dx, proc, lcd, hcc) [45%]
Docs = f(complete, lmn, timely) [30%]
Payer = f(history, level, auth) [25%]
σ(x) = 1 / (1 + e-x)
Trained on 47,000+ appeals · 18 payers · AUC-ROC: 0.84 · Updated quarterly
Decision Thresholds
| Threshold | Recommendation |
|---|---|
| ≥ 75% | Auto-generate appeal + letter |
| 40–74% | Manual review recommended |
| 30–55% (clinical) | Request peer-to-peer review |
| ≤ 20% | Consider write-off |
CARC / RARC Code Library
238 codes · Source: CMS X12 835
| Code | Type | Description | Freq | Overturn | Key Docs Required |
|---|
Payer Intelligence
14 payers · Updated 2024
Market Intelligence
Source: CMS · HFMA · KFF · OIG · AHIMA
US Annual Denials
$262B
CMS + Commercial 2024
Avg Denial Rate
9.5%
HFMA Benchmark 2024
Appeals Overturn Rate
63%
When fully documented
Never Appealed
65%
MGMA · lost revenue
Denial Rate by Provider Type (HFMA 2024)
RCM Appeals Market Size by Segment
Overturn Rates by Appeal Level (CMS / OIG 2024)
Analytics & KPIs
MTD Overturn Rate
68%
↑ 4% vs last month
Revenue Recovered YTD
$1.2M
↑ 18% vs last year
Cost per Appeal
$144
↓ $12 vs last month
Appeal ROI
8.2x
Revenue / cost ratio
Revenue Recovered — 12 Months
Overturn Rate Trend
Denials by Department
Top 5 Revenue Recovery Opportunities
| Denial Code | Volume | Avg $ | Est. Recovery |
|---|---|---|---|
| CO-50 | 82 | $4,200 | $241K |
| CO-4 | 61 | $3,800 | $104K |
| CO-16 | 44 | $2,100 | $78K |
| CO-97 | 38 | $1,900 | $45K |
| CO-197 | 22 | $3,400 | $37K |
Setup & Database Connection
Supabase Database Connection
Supabase → Settings → API → Project URL
Supabase → Settings → API → anon public (safe for frontend)
DB Status: Not connected — using demo data
Required Supabase Tables
| Table Name | CSV File | Status |
|---|---|---|
| carc_denial_codes | IQAppeals_CARC_Denial_Codes.csv | Import needed |
| payer_intelligence | IQAppeals_Payer_Intelligence.csv | Import needed |
| denial_benchmarks | IQAppeals_Denial_Benchmarks.csv | Import needed |
| documentation_requirements | IQAppeals_Documentation_Requirements.csv | Import needed |
| ai_scoring_parameters | IQAppeals_AI_Scoring_Parameters.csv | Import needed |
| market_intelligence | IQAppeals_Market_Intelligence.csv | Import needed |
Free Hosting Options — Recommended Stack
| Service | What it hosts | Free tier | MCP/API Support | How to deploy |
|---|---|---|---|---|
| Netlify ⭐ Best | This HTML app + landing page | 100% Free | Yes — Netlify Functions | Drag & drop HTML files to netlify.com → Add custom domain IQAppeals.com |
| Vercel | React/Next.js app | 100% Free | Yes — Vercel Functions | Connect GitHub repo → auto-deploy on push |
| Cloudflare Pages | Static HTML + Workers | 100% Free | Yes — CF Workers (API) | Upload via Cloudflare dashboard → same DNS you already have |
| Supabase Edge Functions | API / backend logic | Free tier | Yes — Deno functions | Write functions in Supabase → call from your HTML app |
| GitHub Pages | Static HTML only | 100% Free | Limited — no server | Push to GitHub repo → enable Pages in settings → add CNAME |
Step-by-Step: Deploy to IQAppeals.com in 20 minutes (Netlify — Free)
Step 1 — Go to netlify.com → Sign up free with Google
Step 2 — Click "Add new site" → "Deploy manually"
Step 3 — Drag and drop both HTML files (index.html + app.html + jobs.html) into the upload box
Step 4 — Your site is instantly live on a netlify.app URL
Step 5 — Go to Site Settings → Domain management → Add custom domain
Step 6 — Type IQAppeals.com → Netlify gives you 2 DNS records
Step 7 — Go to Cloudflare → DNS → Add those 2 records → Done!
Step 8 — Wait 5 min → IQAppeals.com is live with free HTTPS ✓
Step 2 — Click "Add new site" → "Deploy manually"
Step 3 — Drag and drop both HTML files (index.html + app.html + jobs.html) into the upload box
Step 4 — Your site is instantly live on a netlify.app URL
Step 5 — Go to Site Settings → Domain management → Add custom domain
Step 6 — Type IQAppeals.com → Netlify gives you 2 DNS records
Step 7 — Go to Cloudflare → DNS → Add those 2 records → Done!
Step 8 — Wait 5 min → IQAppeals.com is live with free HTTPS ✓
Connect Supabase (5 min):
1. Open this app.html in a text editor (Notepad)
2. Find line: https://kjeylwfktpwaxflbcywx.supabase.co/rest/v1/
3. Replace with your URL from Supabase → Settings → API
4. Find: sb_secret_krUgJCRLZLvxc6J-jf_-XA_CO7xVxed
5. Replace with your anon key
6. Save file → re-upload to Netlify → DB is live
Or: Use the Setup page → enter credentials → click Connect. They save in browser localStorage automatically.
1. Open this app.html in a text editor (Notepad)
2. Find line: https://kjeylwfktpwaxflbcywx.supabase.co/rest/v1/
3. Replace with your URL from Supabase → Settings → API
4. Find: sb_secret_krUgJCRLZLvxc6J-jf_-XA_CO7xVxed
5. Replace with your anon key
6. Save file → re-upload to Netlify → DB is live
Or: Use the Setup page → enter credentials → click Connect. They save in browser localStorage automatically.