From the moment a denial arrives to the moment it's recovered, Imverra gives your team a command center for the full denial lifecycle — powered by AI, approved by humans.
The Work Queue is your billing team's daily home screen. Every open denial is ranked by AI-computed recovery probability multiplied by dollar value. No more triage by gut feel.
Imverra tracks denial patterns across your practice and flags policy shifts as they happen — not weeks later when your biller notices revenue dropping.
The Command Center gives leadership a real-time view of revenue cycle health — recovery rates, open exposure, aging denials, and trend lines — without pulling reports manually.
Imverra's AI runs four specialized agents in sequence — each with its own confidence gate before passing work to the next stage. No single model tries to do everything. Edge cases are surfaced, not buried.
Reads the EOB and denial codes. Determines denial type, payer rule category, and whether the path forward is an appeal or a corrected claim.
Pulls the applicable LCD, NCD, or payer-specific policy. Extracts the relevant coverage criteria the appeal needs to address. Always current — policy library is updated continuously.
Determines which clinical documentation, payer guidelines, or prior authorization records support the appeal. Flags what's missing and needs to be gathered before submission.
Writes the payer-ready letter: correct format, appropriate tone, full clinical and policy citations in the language that has worked for this payer on this denial type before.
Each agent assigns a confidence score. High-confidence claims queue for fast approval. Low-confidence items are routed to your senior biller with a flag. Nothing goes out on a guess.
The model understands J-codes, infusion sequences, drug-specific coverage policies, step therapy, and substitution rules. It was built for real-world medical billing — not adapted from a general-purpose tool.
Every outcome — payment, denial, biller edit — feeds back as training signal. Accuracy improves with every claim worked. The model gets smarter the longer you use it.
Every design decision — from our data model to our access controls to our vendor selection — starts with HIPAA. PHI is not an afterthought here.
PHI encrypted at rest (AES-256) and in transit (TLS 1.3). Built to HIPAA standards from the ground up, with annual third-party risk assessments planned.
Security controls are designed for SOC 2 Type II readiness. Formal audit engagement is on the roadmap as we onboard founding partners.
Role-based access control with SSO, MFA, and granular permission scopes. No dev access to production PHI. Full audit log on every user action.
Our full subprocessor list is available on request. No PHI touches a vendor that hasn't been reviewed for HIPAA eligibility.
Book a demo and we'll walk through the full platform with a live denial dataset — so you see exactly what your billing team would see on day one.