HIPAA Compliant • No EHR Integration Required • Serving US Healthcare Practices

Stop losing revenue to unworked denials.

ClarixHealth reads your 835 remittance files, identifies appealable denials, scores win probability, and generates appeal letters — so your team focuses on claims most likely to be recovered.

256-bit Encryption
HIPAA Compliant
Works With Any EHR

AI Analysis Complete

Priority Denials
Win Probability
CLAIM ID CARC WIN PROBABILITY ACTION
CLM-2024-001 CO-16
92%
CLM-2024-002 CO-197
85%
CLM-2024-003 CO-50
45%

AI APPEAL LETTER

Generated in seconds

HIPAA Compliant
AES-256 Encryption
Azure Hosted
BAA Available
Works With Any EHR
THE REVENUE CYCLE CHALLENGE

Denial rates are climbing. Manual processes can't keep up.

With initial denial rates reaching 11.8% industry-wide and nearly doubling in the past decade, your billing team needs better tools — not more hours.

Unworked Denials

Nearly 50% of denied claims are never reworked or appealed. Each unworked denial costs $25-30 in lost administrative effort — and the full claim amount in lost revenue.

Appeal Letter Bottleneck

Writing appeal letters takes 15-30 minutes each. With 35% of practices citing staffing as their top RCM challenge, there simply aren't enough hours in the day.

No Denial Analytics

Without CARC code analysis and payer trend data, you can't identify which denials to prioritize or which payers are systematically underpaying you.

The Denial Crisis by the Numbers

These are the industry-wide challenges driving the need for better denial management tools.

11.8%

Average Initial Denial Rate

Initial claim denial rates hit 11.8% in 2024 — nearly double from a few years earlier. The trend continues to climb.

Source: Experian State of Claims Report

~50%

Denied Claims Never Reworked

Nearly half of all denied claims are never appealed or reprocessed — leaving recoverable revenue on the table.

Source: MGMA Industry Data

$20B

Annual Cost of Denial Rework

Denial rework costs American healthcare providers an estimated $20 billion per year in administrative overhead.

Source: Industry Research

Complete Denial Management Software

Everything your revenue cycle team needs to identify, prioritize, and appeal denials.

835 EDI Analytics

Parse remittance advice files instantly. See CARC codes, adjustments, and denial patterns in a clear dashboard.

AI Appeal Letters

Generate payer-specific appeal letters in seconds. Our AI cites relevant medical policies and CARC code requirements.

Win Probability Scoring

Prioritize denials by likelihood of successful appeal. Focus your team on high-value, high-probability claims.

Works With Any EHR

Standalone solution that overlays your existing billing system. No complex integration or data migration required.

Denial Root Cause Analysis

Identify recurring denial patterns by CARC code, payer, and procedure. Fix issues upstream before they become denials.

Revenue Recovery Tracking

Track appeal outcomes and recovered revenue. Measure ROI and demonstrate value to practice leadership.

SEE IT IN ACTION

Ready to recover more denied revenue?

Book a 15-minute walkthrough and see how ClarixHealth works with your 835 files.

PLANS

Transparent pricing. No surprises.

We only get paid when we recover your revenue. Choose the plan that fits your practice.

GROWTH

For growing practices

Ideal for practices processing up to 1,000 claims per month.

Up to 1,000 claims/month
50 AI appeal letters/month
AI-powered denial analysis
Win probability scoring
Email support

$299/mo

+ 12% of recovered revenue

Schedule Demo
MOST POPULAR

PROFESSIONAL

For established practices

Unlimited claims and AI appeal letters with full platform access.

Unlimited claims
Unlimited AI appeal letters
AI letter generation
AI chatbot assistant
Email + phone support

$599/mo

+ 10% of recovered revenue

Schedule Demo

ENTERPRISE

For large organizations

Custom configuration with dedicated support, API access, and SLA guarantees.

Everything in Professional
Dedicated CSM
API access
SFTP integration
SLA guarantee

Custom

Tailored to your organization

Contact Sales
HIPAA Compliant
Guided onboarding
Cancel anytime

Frequently Asked Questions About Denial Management

What is denial management software?

Denial management software helps healthcare practices identify, analyze, and appeal claim denials more efficiently. ClarixHealth specifically parses 835 EDI remittance files, categorizes denials by CARC code, calculates win probability for each appeal, and generates AI-powered appeal letters — all without requiring EHR integration.

Does ClarixHealth work with Epic, Cerner, or Athena?

Yes. ClarixHealth is a standalone solution that works with 835 EDI files, which are the industry standard across all EHR and practice management systems. You simply export your remittance files and upload them — no complex integration, no IT involvement required.

Is ClarixHealth HIPAA compliant?

Yes. We use enterprise-grade AES-256 encryption for data at rest and TLS 1.2+ for data in transit. We sign a Business Associate Agreement (BAA) with every paid account and maintain full HIPAA compliance including audit logging and access controls.

How does the AI appeal letter generator work?

Our AI analyzes the denial reason (CARC/RARC codes), claim details, and payer-specific requirements to generate a customized appeal letter. Each letter includes relevant medical policy citations and addresses the specific denial reason. You can review, edit, and send in minutes instead of hours.

What is win probability scoring?

Win probability is our algorithm that predicts the likelihood of a successful appeal based on the CARC code, payer history, claim age, and dollar amount. This helps your team prioritize which denials to work first — focusing effort on claims most likely to be recovered.

How quickly can I get started?

About 5 minutes. Create an account, upload your 835 files, and see your denial analytics immediately. No IT integration, no data migration, no training required. You can also try our interactive demo right now to see the product in action before signing up.

Can I book a demo to see ClarixHealth in action?

Absolutely. You can book a free 15-minute walkthrough where we'll show you how ClarixHealth works with real 835 files. We'll demonstrate the denial analytics dashboard, win probability scoring, and AI appeal letter generation. No commitment required.