Denial Pilot Information

DenialPilot is not prior authorization software. It is a payer rules reference for surgical procedures. The auth software market is crowded. Dozens of products promise to automate submissions, integrate with the EHR, and route requests faster. None of them address the part of the workflow that actually consumes the most staff time: the research that happens before anything gets submitted. Every surgical authorization starts with the same question. What does this payer require for this procedure, on this plan, right now? The answer is buried across hundreds of pages of medical policies, delegated reviewer guidelines, portal instructions, and documentation requirements that change without notice. Even an experienced coordinator who knows her highest-volume CPT codes still spends 5 to 45 minutes per case verifying what applies — because the rules, routing, and thresholds keep changing. Every case. Every payer. Every time. DenialPilot replaces that research step. Staff search the procedure and the payer, see the exact thresholds and documentation requirements that apply, and move on. 60 seconds instead of 30 minutes. What that gives a practice, in order of what matters most: Hours back. Dozens of staff hours per week returned to the team — universal regardless of whether the practice runs at 8% denials or 28%. Drastically fewer denials. The buried rules — washout periods, BMI thresholds, conservative care durations, plan-type variations — become visible before submission, not after the denial arrives. A team that doesn't dread the work. The biller stops feeling rigged against. The administrator stops absorbing escalations. The surgeons stop losing cases to administrative friction. Less time fighting the payer. More revenue. Less of the games. DenialPilot calls this category Healthcare Revenue Defense. Built for the people doing this work.