Fragmented Materials
Patient intake, denial letters, medical records, physician statements, and prior appeals live in different systems, formats, and folders — with no structured connection between them.
The hardest part of a health insurance appeal isn't writing the final letter. It's finding the right facts, understanding the denial, identifying missing support, and assembling the strongest medical and legal argument — before the deadline.
ClearIQ gives legal-medical teams immediate case orientation: structured intake, denial analysis, AI-assisted fact extraction, and an attorney-reviewable appeal workspace — from first intake to final package.
Built for attorneys, patient advocates, healthcare appeal specialists,
and legal-medical case managers.
Your team works across scattered intake notes, denial letters, medical records, physician support letters, and prior appeal work product — under deadline pressure, without a shared structure, and with no way to systematically surface what's missing.
Patient intake, denial letters, medical records, physician statements, and prior appeals live in different systems, formats, and folders — with no structured connection between them.
Health insurance appeals operate under strict external deadlines. Missed windows mean closed cases. The cost of a disorganized workflow is measured in lost appeals — and patient outcomes.
Every case starts from scratch. Knowledge from past appeals — winning arguments, effective physician letters, denial patterns — is locked in documents, inboxes, and institutional memory.
Physician letters and clinical documentation are frequently incomplete, late, or misaligned with the legal arguments required for the specific denial reason — gaps that only surface at final review.
The facts that win the appeal exist — somewhere across denial letters, medical records, and physician notes. Attorneys spend hours finding them before they can begin the actual advocacy work. That is the orientation problem.
Without a standard intake and documentation structure, appeal packages vary in completeness and quality across attorneys, advocates, and case managers — creating risk and rework.
ClearIQ creates a single, structured thread from the first intake form to the final appeal package — so nothing is scattered, nothing is missed, and expert judgment can focus on what matters.
Structured patient and case intake captures the information needed for a complete appeal file — consistently, across every case.
Upload the denial letter. ClearIQ extracts the denial reason, coverage language, and insurer's stated basis — ready for legal and clinical review.
Structured interview guides and transcription tools capture patient-reported information, treatment history, and functional impact in a reviewable format.
Medical records, treatment notes, and physician documentation are parsed to surface clinically relevant facts mapped to the denial reason.
The case is assessed for appeal viability based on denial type, supporting documentation strength, and alignment with coverage standards.
ClearIQ identifies gaps in clinical documentation, physician support, and legal argument — before the appeal is drafted.
All extracted facts, arguments, and gaps are presented in a structured workspace for expert review, annotation, and decision-making.
A complete, formatted appeal package — cover letter, argument structure, supporting documentation index — is generated for final expert review and submission.
When the insurer approves, recovery and disbursement activates automatically — calculating fee splits, coordinating multi-party disbursements, and reconciling remittances without a separate billing workflow.
Human judgment stays in control at every step. ClearIQ organizes and surfaces — attorneys and advocates decide.
When the insurer approves, the administrative work shouldn't start over. ClearIQ's integrated recovery and disbursement module tracks outcomes, calculates fee allocations, coordinates multi-party disbursements, and reconciles insurer remittances — triggered automatically the moment an appeal is marked approved.
For legal-medical teams working on contingency or fee-for-service models, this closes the loop that has historically required a separate billing team, a separate system, and weeks of manual follow-up. ClearIQ handles it as part of the same case workspace.
Appeal results are logged directly in the case workspace. An approved decision automatically activates the recovery workflow — no manual handoff, no separate system, no delay.
For legal teams working on contingency, fee splits are calculated automatically against the approved claim amount using your firm's configured fee structures — no manual arithmetic, no spreadsheet reconciliation.
Approved claim amounts are allocated across every party in the disbursement chain — lead counsel, co-counsel, referring advocates, medical providers, lien holders, and patient — with configurable allocation rules applied per case.
Incoming EFT and ACH remittances from insurers are matched against approved claims in real time. Discrepancies — underpayments, missing payments, partial releases — are flagged automatically before they become collection problems.
Every case maintains a complete, auditable recovery record — approved claim amount, fee splits, disbursements issued, outstanding balances, lien satisfactions, and full disbursement history. One record, fully traceable.
Firm-level and advocate-level reporting across approved appeal revenue, pending disbursements, open balances, and payment pipeline — giving managing partners and finance teams a real-time view of where every dollar stands.
From patient intake and denial letter through appeal package, insurer approval, and full recovery disbursement — ClearIQ manages the complete lifecycle in one structured workspace.
Generic AI writing tools generate text. ClearIQ structures your case. A health insurance appeal is not primarily a writing problem — it is a fact triage and argument assembly problem. The right facts exist somewhere across intake notes, denial letters, medical records, and physician input. ClearIQ finds them, organizes them, and surfaces what's missing, so the attorney can start where it matters — not at page one.
Join the WaitlistFrom the moment a matter is opened, ClearIQ gives attorneys and advocates a structured view of the strongest facts, missing support, and denial basis — so expert judgment starts at the right place, not at square one.
ClearIQ extracts and structures clinically and legally relevant facts from your actual case materials — it does not generate unsupported narrative.
Missing physician letters, incomplete clinical documentation, and unaddressed denial arguments are identified before drafting begins — not discovered at final review.
Every extracted fact, argument theme, and generated draft is flagged for attorney or advocate review. The workspace is built around human judgment, not around AI confidence.
Successful arguments, physician letter patterns, and denial-specific strategies from past appeals inform future case preparation — without starting from scratch every time.
Six purpose-built modules that take a case from denial intake to submission-ready appeal package — with expert review at the center.
Every case is assessed for appeal viability across denial type, clinical documentation quality, insurer argument, and applicable coverage standards — giving teams a structured read before committing resources.
Denial letters are parsed to extract the insurer's stated basis, coverage language cited, and specific policy provisions invoked — translating insurance-speak into structured, actionable review.
Missing, incomplete, or clinically misaligned physician letters are flagged before drafting begins — with structured prompts identifying what documentation is needed and why.
Winning arguments, effective physician letter structures, and denial-specific strategies from past cases inform future case preparation — without reinventing the wheel every time.
Extracted facts, argument themes, documentation gaps, and generated drafts are presented in a structured workspace designed for attorney and advocate review, annotation, and decision-making.
A complete, formatted appeal package — cover letter, argument structure, clinical documentation summary, and supporting exhibit index — generated for final expert review and submission.
ClearIQ is purpose-built for legal-medical professionals who work under deadline pressure with fragmented materials and high stakes.
Attorneys managing appeal caseloads need faster fact organization, structured documentation review, and editable draft output — without sacrificing the analytical judgment that wins appeals.
Advocates working on behalf of patients need a structured way to capture intake, gather medical evidence, and prepare complete appeal submissions — without an attorney's office behind them.
Appeal specialists handling high-volume denial management need repeatable workflows, denial reason classification, and structured output that scales across case types and insurers.
Case managers coordinating between patients, physicians, and legal teams need a shared workspace that keeps everyone aligned — from intake through final submission.
Clinical staff supporting appeal efforts need structured templates and clear documentation guidance to ensure physician letters and clinical records are aligned with the specific denial being appealed.
ClearIQ is in active development. Join the waitlist to shape the product and be among the first teams to use it.
Thank you for your interest in ClearIQ. We'll be in touch as the product develops — and you'll hear from us first when early access opens.