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The tracking view

All submitted appeals live in Appeals → Tracking. Filter by status, payer, assignee, or deadline window.

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Deadline and follow-up reminders

1

Automatic deadline compute

The payer’s response SLA is computed from the submission date and the specific appeal type (first-level, second-level, external review).
2

Reminder cascade

  • T-14 days: Light reminder in inbox.
  • T-7 days: Email + in-app notification to the assignee.
  • T-1 day: Escalation to the assignee’s manager.
  • T+0: Automatic follow-up task created.
3

Follow-up action

On overdue response, we draft a follow-up letter or phone-call script and surface it as an action item.

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Capturing outcomes

When the payer responds:
  • If the response is a formal letter — upload it (or let it sync from your EHR/scan-to-email). Denialbase extracts the outcome automatically.
  • If the response was verbal (phone, peer-to-peer) — click Record outcome and fill in the fields.
Outcomes capture:
  • Final amount approved (if any)
  • Reference / claim number
  • Notes (e.g. “provider agreed after peer-to-peer”)
  • Follow-up needed (e.g. “resubmit with modifier”)

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Reporting

Dashboards

Overturn rate by payer, denial type, provider, and strategy. Trend over time. Filterable and exportable.

Per-payer performance

Which payers have the highest overturn rates for your practice? Which are slowest to respond? All sliceable.

Financial recovery

Total dollars recovered this month / quarter / year. By payer, by provider, by billing staff member.

Exports

CSV, XLSX, or JSON. All exports are audit-logged per HIPAA requirements.

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Learning loops

Every outcome is fed back into the system in three ways:
The overturn-probability estimate for similar future denials is updated based on the actual outcome.
If your edits materially changed the submitted letter, those edits inform the drafts for similar future appeals — tuned to your practice’s voice.
Patterns across many practices — “Kaiser overturns 80% of coverage_exclusion denials when peer-to-peer is requested” — feed the insurer-specific guides at Insurer guides.

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External / IRO review

When a first-level appeal is upheld and the amount justifies escalation:
  • For ERISA plans: external review via an IRO.
  • For state-regulated plans: state insurance department review.
  • For Medicare/Medicaid: ALJ hearing or state fair hearing.
Denialbase will surface the correct next-level appeal channel based on the plan type and jurisdiction, and pre-fill the escalation packet.

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Exporting the full appeal history

For audit or transition purposes, you can export the complete appeal history for any patient or the whole practice:
  • Settings → Data → Export → Appeals — generates a downloadable archive (documents + metadata) within 10 minutes.
  • Every export is audit-logged per HIPAA §164.312(b).