Public tools use non patient data Customer deployment available No live EHR connection
Specialty Denial Defense Platform

PriorZap: clear orders, overturn denials, recover remittances

Prior authorization and denial defense built for oncology, rheumatology, neurology, dermatology, GI, and orthopedics practices. Free diagnostic tools, $19 verified appeal packets, and $499/mo Revenue Shield with 835 takeback scanning.

67% of denied claims are never appealed. The average specialty clinic writes off six figures a year to preventable denials, not because they lost, but because they ran out of time.
67%
of denied claims are never appealed (KFF 2023)
$127K
avg revenue a clinic writes off annually
65%
appeal overturn rate with evidence-backed letters
[CRD-PRECHECK]

Prior Auth Checker

Instantly see prior-auth, step-therapy, and documentation requirements for any drug and payer. Outputs an EHR SmartPhrase macro.

Try free →
[APPEAL-PACKET]

Appeal Generator

Draft an evidence-backed medical necessity appeal packet in under 60 seconds with citations, peer to peer script, and escalation kit.

Generate packet →
[835-CARC]

Denial Code Decoder

Translate any CARC/RARC denial code into plain English, appealability, and your next action.

Decode a code →
[ROI-CALC]

Denial ROI Calculator

See exactly how much denied revenue your clinic can recover and how many staff hours automation saves.

Calculate ROI →

Four levels of denial defense, every time

PriorZap does not stop at a draft letter. Every packet carries the full escalation chain so your clinic can escalate without hiring another billing specialist.

Level 1: Initial Appeal
Evidence-backed medical necessity letter with PubMed / NCCN / ACR citations and payer policy cross reference.
Level 2: Peer to Peer
MD talking points and objection-response bank matched to your payer and drug class.
Level 3: External Review
Independent Review Organization (IRO) filing package for MD, VA, DC plans.
Level 4: Commissioner
State Insurance Commissioner complaint when payers breach CMS-0057-F turnaround windows.

PriorZap Revenue Shield ($499/mo per clinic)

Deploy an AI agent that watches your remits, drafts appeals, escalates automatically, and scans every 835 remittance for takebacks, with no extra staff required.

What VerbaFlow builds for providers

The free tools above prove the approach. VerbaFlow designs and ships full-production healthcare tech on your timeline, deployed in your environment, integrated with your EHR.

[AUTONOMOUS]
Autonomous Denial Defense Agent

A per-clinic AI that monitors remits, drafts appeals, and escalates automatically. No extra staff required.

[EHR]
EHR Integration

CDS Hooks, FHIR R4, HL7 v2: embed denial prevention inside Epic, Oracle Health, or athenahealth.

[RCM]
Revenue Cycle Automation

Claims submission, remittance parsing, prior auth workflows: end to end RCM tooling built to your process.

[PORTAL]
Patient-Facing Portals

Coverage lookup, financial assistance screeners, PA status trackers built for your patient population.

[POLICY]
Payer Policy Intelligence

Automated policy monitoring, win rate tracking, and appeal strategy optimization across your payer mix.

[CUSTOM]
Custom Build

Need something specific? We scope it, price it, and build it. Tell us what your practice needs.

Enterprise Modules: Dedicated PHI Enclave

For health systems, ACOs, and hospital groups that need live EHR feeds and isolated PHI processing. These run inside a dedicated priorzap-phi GCP project (ADR-121) behind Cloudflare Access, not on the public edge.

Inpatient DRG Defense
Clinical documentation integrity validation and MS-DRG downgrade appeal defense (Sepsis-3 → Sepsis-1, CC/MCC recoupment). Sold to hospital CFOs on contingency.
ACO Quality & HCC
Real time care gap detection, RAF risk adjustment documentation, and HEDIS / Star rating compliance tracking for MSSP and Medicare Advantage networks.
Custom EHR Agents
Bespoke CDS Hooks, order sign pre checks, and denial prevention agents embedded inside your Epic, Oracle Health, or athenahealth workflow.

Get a free denial defense assessment

Tell us about your practice and we will identify which denials are costing you the most and what would take the least time to fix.