Built and trusted by
AI BPO recovers revenue for healthcare providers and billing teams by automating insurance denial appeals.
Appeal success rate estimate
Automated claims monitoring
Faster revenue recovery
Built and trusted by
Three steps to recover more revenue from denied claims
AI BPO automatically identifies denied claims and reorganizes them by likelihood of success and potential revenue recovery. Focus your efforts where they matter most.
3 claims prioritized for immediate action
Cigna
03/13/2024
Procedure: Laboratory Tests - Comprehensive Panel
Duplicate claim submission for same service date
Aetna
03/14/2024
Procedure: Surgical Consultation & Treatment
Out-of-network provider - benefits limited per plan
UnitedHealthcare
03/15/2024
Procedure: Physical Therapy (12 sessions)
Medical necessity not established per policy guidelines
Using insurance policies, medical codes, and your documentation, AI BPO drafts comprehensive appeals. When phone calls are needed, it can make them—escalating to your team only when human judgment is required.
Denial #CLM-2024-001237
RE: Appeal of Claim Denial
Claim: CLM-2024-001237 | Patient: David Kim
Service Date: March 13, 2024
Dear Appeals Committee,
AI BPO handles submission across multiple payer portals and tracks every appeal through to resolution. Get real-time updates on approval rates and recovered revenue.
Everything needed to automate denial appeals from identification to resolution
Generate customized appeal letters using your medical records, policy guidelines, and denial codes. Example: Drafts a 3-page appeal for a denied MRI with supporting documentation.
Make outbound calls to verify appeal receipt, check status, and document payer responses. Example: Calls Aetna to confirm appeal submission and logs case notes.
Route peer-to-peer reviews and clinical escalations to your team with full context. Example: Flags surgical authorization denial for physician review with complete medical history.
Connect to Epic, Cerner, or any EHR to retrieve patient records and clinical documentation. Example: Extracts lab results and diagnosis codes from Epic for appeal evidence.
Study coverage policies and medical necessity criteria for each insurance company. Example: References UnitedHealthcare's PT authorization guidelines when drafting appeals.
Create multi-step processes for different denial types and clinical scenarios. Example: Sets up 3-tier workflow for pre-auth denials with automatic follow-up timelines.
See how businesses replaced outsourcing with AI workers
"We were writing off thousands of denied claims annually. AI BPO now handles our appeals automatically and we're recovering the majority of previously denied revenue."
"Prior authorization denials were killing our practice efficiency. AI BPO drafts appeals with supporting documentation in minutes instead of hours."
Integrate seamlessly with EHRs (Epic, Cerner, Athenahealth), billing systems (Waystar, Change Healthcare), clearinghouses (Availity, Trizetto), and payer portals. Custom integrations built for your workflow.
Stanford team backed by tier 1 VCs
AI BPO is built by Om Labs, a Stanford team with backgrounds from Oracle, Microsoft, and Uber. We're backed by Alliance, Balaji Srinivasan, Some Capital, and other leading investors with over $1B in AUM who share our vision for AI-native operations.
Founded by Krish Chelikavada and Keon Kim, our team has written bestselling AI books and built operational workflows at unicorns and billion-dollar SaaS companies. We've created support agents, QA agents, and entire automated workflows that replace traditional BPO functions.
Before AI BPO, we spent years watching companies struggle with offshore teams, dealing with time zones, quality issues, and scaling constraints. We built this because we know companies need automation that works like an extension of their team, not another vendor to manage.