> ## Documentation Index
> Fetch the complete documentation index at: https://trust.denialbase.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Filing appeals

> Generate citation-backed appeal letters, sign, submit, and track — all in one flow.

## The filing flow

<Steps>
  <Step title="Start an appeal">
    From a denial's detail view, click **Start appeal**. The strategy recommendation is pre-selected; you can change it.
  </Step>

  <Step title="Review the draft">
    Within \~60 seconds, the AI drafts the appeal letter with pulled medical records, policy citations, and clinical rationale. You see a side-by-side view with the original denial.
  </Step>

  <Step title="Edit if needed">
    Rich-text editor for the letter body. Any edits you make are tracked and fed back into learning — this is how the drafting gets tuned to your practice's voice.
  </Step>

  <Step title="Attach supporting docs">
    Upload or pull in operative reports, chart notes, medical necessity letters, and any payer-specific forms. PHI-encrypted, audit-logged.
  </Step>

  <Step title="Sign">
    Route to DocuSeal. The provider signs electronically. Or, if your practice permits, a staff member signs on behalf of the provider with a stored delegation.
  </Step>

  <Step title="Submit">
    Choose the payer's preferred channel — portal upload, fax (via a HIPAA-ready fax provider with BAA), or certified mail (with automatic tracking number capture). Submission receipt stored with the appeal.
  </Step>
</Steps>

## What goes into the draft

<AccordionGroup>
  <Accordion title="Appeal rights language">
    Pulled from the denial letter — always cited with the exact source language and date the denial was received.
  </Accordion>

  <Accordion title="Medical necessity argument (if applicable)">
    Built from the patient's chart notes, diagnoses, and procedure history. The AI pulls only the relevant records — we don't dump the chart.
  </Accordion>

  <Accordion title="Policy / regulatory citations">
    Plan-specific language when we have it, plus state and federal citations (ERISA, ACA, state insurance codes).
  </Accordion>

  <Accordion title="Peer-reviewed literature (where appropriate)">
    For medical necessity appeals, we pull 2–3 peer-reviewed sources supporting the clinical rationale.
  </Accordion>

  <Accordion title="Provider voice">
    Over time, drafts are tuned to match your practice's tone based on your past edits.
  </Accordion>
</AccordionGroup>

## Signing

<CardGroup cols={2}>
  <Card title="DocuSeal e-signature" icon="file-signature">
    Provider receives an email, reviews the letter, signs. Signature is audit-logged and embedded in the PDF with a tamper-evident hash.
  </Card>

  <Card title="Delegated signing" icon="user-shield">
    Practice admins can grant specific staff the authority to sign on behalf of a provider. Every delegated signature is audit-logged with the delegator, delegate, and time-scope.
  </Card>
</CardGroup>

## Submission channels

| Channel               | When to use                               | What we do                                                            |
| --------------------- | ----------------------------------------- | --------------------------------------------------------------------- |
| **Payer portal**      | When the payer requires portal submission | Direct upload (where API available) or guided manual upload checklist |
| **Fax**               | Payers with fax-only appeals              | HIPAA-ready fax via integrated provider with BAA; confirmation stored |
| **Certified mail**    | When the payer's policy requires it       | Label generated; tracking number captured into the appeal record      |
| **In-person courier** | Rare — specific payers                    | Documented in insurer guide if applicable                             |

## After submission

<Steps>
  <Step title="Receipt captured">
    Confirmation number, portal timestamp, fax transmit receipt, or mail tracking number — whatever the channel provides.
  </Step>

  <Step title="Deadline tracker">
    The payer's response window is computed and displayed. You'll get reminders at the 14-, 7-, and 1-day marks.
  </Step>

  <Step title="Follow-up">
    If we don't hear back by deadline, the denial is auto-surfaced for follow-up action.
  </Step>

  <Step title="Outcome capture">
    When you mark the outcome (approved / partially approved / denied), we feed the result back into the strategy model and your practice's reporting.
  </Step>
</Steps>

## Quality gates

* No appeal can be submitted without a generated PDF.
* No appeal can be submitted without a valid signature (provider or delegated).
* Appeals for denials with a deadline \< 24 hours require a second confirmation.
* Audit log records every draft edit, signature, and submission.

## Limitations

<AccordionGroup>
  <Accordion title="We don't file appeals automatically">
    Every appeal requires explicit human approval and signature. We are not — by design — an autonomous claims bot.
  </Accordion>

  <Accordion title="We don't guarantee overturn">
    The strategy recommendation includes an overturn probability, but outcomes depend on the specifics of each case and payer. You stay in charge of what to file.
  </Accordion>

  <Accordion title="We don't replace your provider's clinical judgment">
    For medical necessity appeals, the provider must review the clinical rationale before signing.
  </Accordion>
</AccordionGroup>