Level-of-care routing
Separate medical necessity, level of care, continued stay, prior authorization, coding, network, and benefit issues before the team starts drafting.
For behavioral-health revenue cycle teams
Make every behavioral-health denial easier to route, review, and appeal.
ClaimParrot drafts appeal packets for IOP, PHP, residential, inpatient, detox, outpatient, SUD, and ABA denials from de-identified summaries: payer routing, evidence readiness, peer-to-peer prep, and a deadline plan, with a person checking every packet.
Editable drafts. Human review before delivery.
Adverse-benefit determination
CP-1048 · Fictional sample · no PHI
Payer familyOptum / United Behavioral Health
Care settingIOP
Review stageConcurrent review
Denial categoryMedical necessity · continued stay
Criteria sourcePayer level-of-care guideline (named in the notice, not reproduced)
Deadline180 days stated in the notice · verify against the plan
Next actionClinical appeal · peer-to-peer available
The workflow
From intake to a reviewable packet.
- 01
Route the decision
Send a de-identified summary of the adverse-benefit determination: the stated reason, care setting, review stage, payer codes, and criteria source printed in the notice. No names, ID numbers, or dates.
- 02
Close evidence gaps
Prepare treatment-plan, symptom, functional-impairment, authorization, progress, risk, and discharge records with a checklist matched to the denial route.
- 03
Review the packet
The packet engine drafts the letter and peer-to-peer brief, a person checks it before release, and your clinician fills in the patient details, signs, and submits.
Built for the work
Less packet assembly. More informed review.
The interface keeps the notice, evidence, deadline, draft, and approval state connected to the same case.
Clinical evidence readiness
Track the records a reviewer still needs without inventing symptoms, diagnoses, risk findings, treatment response, or payer criteria.
Peer-to-peer preparation
Turn the payer's stated rationale into neutral clarification questions for a qualified same-specialty clinician.
No PHI, no BAA
Requests are de-identified and packets come back with placeholders, so no protected health information reaches ClaimParrot and no BAA is needed.
Start with one denial
Send a denial. Get the appeal packet back.
Software drafts every packet from a de-identified summary and a person checks it before it reaches you. No contract and no patient data.
Appeal packets
From $29 / packet
$99 for a level-of-care packet with a criteria crosswalk and peer-to-peer brief. Delivered within 3 business days; your first packet is free.
A recurring workspace
Keep the team, evidence, and next action aligned.
Designed for recurring claim operations, with a clear human approval boundary around every generated packet.
De-identified design-partner pilot
$500 / 30 days
Up to 50 fictional or properly de-identified denials, two users, one queue import, weekly workflow review, paired preparation-time measurement, and an end-of-pilot scorecard. Waived for the first three design partners who agree to a published case study. No outcome promise and no patient data.
Example workflows
What the workflow organizes.
Representative product examples, not verified customer outcomes.
Example utilization-review workflow
A continued-stay denial should enter the queue with the care setting, remaining evidence gaps, and peer-to-peer path already visible.
Fictional product scenario - no outcome claim
Example billing-review workflow
The draft is useful because the team can see what came from the payer notice, what came from the record, and what still needs human verification.
Fictional product scenario - human approval required
Questions
Questions behavioral-health teams ask
No. It organizes the payer's stated rationale and your de-identified summary into a draft packet. Qualified clinical and billing staff remain responsible for medical-necessity, coding, criteria, deadline, and submission decisions.
No. ClaimParrot identifies a criteria source when the payer notice names it and helps staff organize the documented facts. Your organization must use properly licensed criteria and payer materials for the actual review.
The scorecard compares a team-provided preparation-time baseline with observed ClaimParrot preparation time, packet acceptance without structural rework, missing evidence caught, reviewer ratings, and recorded payer outcomes. These are workflow observations, not guaranteed reimbursement results.
No, at any stage. ClaimParrot accepts de-identified information only and does not sign business associate agreements, so none is needed. The form blocks names, ID numbers, dates, and contact details, and the packet comes back with placeholders your team fills in.
Reviewed by a person.Every packet.