Clinical Appeals Automation

JSON twin: https://www.healthaidb.com/software/clinical-appeals-automation.json

Company Name

Crosby Health

Product URL

https://www.crosbyhealth.com

Company URL

https://www.crosbyhealth.com

Categories

• administrative Operations
• clinical Care
• patient Facing
• diagnostic Support
• revenue Cycle
• healthcare It
• ai Clinical Documentation Integrity
• ehr Integration
• payer Solutions
• Administrative
• Clinical
• Diagnostic
• Revenue Cycle Management
• Ai Integration
• Payer Integration
• Appeals Management

Summary

Crosby Health's Clinical Appeals Automation streamlines the process of generating, submitting, and tracking clinical appeals, reducing the administrative burden on healthcare providers and enhancing recovery rates from denials.

Description

Crosby Health offers an AI-driven platform that automates the creation and management of clinical appeal letters. Utilizing Apollo, a clinical language model trained for revenue cycle management tasks, the platform generates precise appeal letters, submits them to various payors, and tracks their status, thereby improving efficiency and recovery rates for healthcare providers. The system integrates with multiple Electronic Health Records (EHRs) and payer systems, including Epic, MEDITECH, Cerner, Net Health, CMS, and UnitedHealthcare, facilitating seamless data exchange and communication. Crosby Health's solution is designed for hospitals, health systems, and specialty practices, aiming to alleviate the administrative burden associated with clinical denials and allow providers to focus more on patient care. The company was founded in 2022 and is headquartered in New York City, with an administrative office in Crosby, Texas. As a privately held entity, Crosby Health has secured early-stage venture capital funding, with a reported valuation of $2.2 million as of 2024. The platform is accessible via web applications and supports integration with over 90 EHRs, ensuring compatibility with a wide range of healthcare systems. Crosby Health's mission is to revolutionize the clinical appeals process by leveraging artificial intelligence to automate and optimize workflows, ultimately enhancing financial outcomes for healthcare providers.

Api Available

yes

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO

Company Founding

2022

Company Offices

• United States

Compliance

• HIPAA
• GDPR
• HITECH
• SOC 2
• ISO 27001

Customers

• EmpowerMe

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS
• on_prem
• hybrid

Features

• Automated appeal generation
• Medical necessity identification
• Unified submission to all payors
• Automated tracking and confirmation of receipt
• Immediate notifications of payor decisions
• Integration with legal and clinical guidelines
• AI-driven analysis of clinical documentation
• Support for small balance recovery
• Integration with CMS for electronic submission
• Integration with Cerner for enhanced appeal writing

Id

SW1184

Integration Partners

• Epic
• MEDITECH
• Cerner
• Net Health
• CMS
• UHC

Integrations

• CMS
• Cerner

Languages Supported

• English

Last Updated

2025-10-11

License

Commercial

Market Segment

• Enterprise
• SMB
• Consumer

Optional Modules

• Medical coding
• Chart auditing

Os Platforms

• Web
• iOS
• Android
• Windows
• macOS
• Linux

Pricing Details

Contact vendor for pricing information.

Pricing Model

Subscription

Privacy Features

• BAA available
• consent mgmt
• anonymization
• data minimization

Product Code

SW1184

Product Name

Clinical Appeals Automation

Ratings

• 91.8% on medical license board exam questions, surpassing every other clinical LLM available today. ([alleywatch.com](https://alleywatch.com/2024/05/crosby-health-clinical-llm-appeals-claims-denial-automation-medical-coding-insurance-rishi-gowda/?utm_source=openai))

Regions Available

• United States

Related Urls

• https://elion.health/products/crosby-health

Release Year

2024

Security Features

• Encryption
• RBAC
• SSO/SAML
• audit logs
• 2FA
• DLP

Specialties

• Radiology
• Cardiology
• Orthopedics
• Neurology
• Oncology
• Pediatrics
• Obstetrics
• Gynecology
• Dermatology
• Gastroenterology
• Pulmonology
• Endocrinology
• Urology
• Ophthalmology
• Ent
• Psychiatry
• Anesthesiology
• Pathology
• Emergency Medicine
• Family Medicine

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Major OS/DB/hardware needs, or empty if SaaS-only

Target Users

• Clinicians
• Nurses
• Patients
• Admins
• Payers

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Using Apollo has enhanced our appeal team’s efficiency and streamlined our revenue cycle management tasks at hyperspeed.
• Partnering with Crosby Health and having access to Apollo has completely revamped our organization and saved us time and team bandwidth.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Clinical Appeals Automation",
  "company_name": "Crosby Health",
  "product_url": "https://www.crosbyhealth.com",
  "company_url": "https://www.crosbyhealth.com",
  "related_urls": [
    "https://elion.health/products/crosby-health"
  ],
  "product_code": "SW1184",
  "summary": "Crosby Health's Clinical Appeals Automation streamlines the process of generating, submitting, and tracking clinical appeals, reducing the administrative burden on healthcare providers and enhancing recovery rates from denials.",
  "description": "Crosby Health offers an AI-driven platform that automates the creation and management of clinical appeal letters. Utilizing Apollo, a clinical language model trained for revenue cycle management tasks, the platform generates precise appeal letters, submits them to various payors, and tracks their status, thereby improving efficiency and recovery rates for healthcare providers. The system integrates with multiple Electronic Health Records (EHRs) and payer systems, including Epic, MEDITECH, Cerner, Net Health, CMS, and UnitedHealthcare, facilitating seamless data exchange and communication. Crosby Health's solution is designed for hospitals, health systems, and specialty practices, aiming to alleviate the administrative burden associated with clinical denials and allow providers to focus more on patient care. The company was founded in 2022 and is headquartered in New York City, with an administrative office in Crosby, Texas. As a privately held entity, Crosby Health has secured early-stage venture capital funding, with a reported valuation of $2.2 million as of 2024. The platform is accessible via web applications and supports integration with over 90 EHRs, ensuring compatibility with a wide range of healthcare systems. Crosby Health's mission is to revolutionize the clinical appeals process by leveraging artificial intelligence to automate and optimize workflows, ultimately enhancing financial outcomes for healthcare providers.",
  "categories": [
    "administrative Operations",
    "clinical Care",
    "patient Facing",
    "diagnostic Support",
    "revenue Cycle",
    "healthcare It",
    "ai Clinical Documentation Integrity",
    "ehr Integration",
    "payer Solutions",
    "Administrative",
    "Clinical",
    "Patient-facing",
    "Diagnostic",
    "Revenue Cycle Management",
    "Healthcare It",
    "Ai Integration",
    "Ehr Integration",
    "Payer Integration",
    "Appeals Management"
  ],
  "market_segment": [
    "Enterprise",
    "SMB",
    "Consumer"
  ],
  "target_users": [
    "Clinicians",
    "Nurses",
    "Patients",
    "Admins",
    "Payers"
  ],
  "specialties": [
    "Radiology",
    "Cardiology",
    "Orthopedics",
    "Neurology",
    "Oncology",
    "Pediatrics",
    "Obstetrics",
    "Gynecology",
    "Dermatology",
    "Gastroenterology",
    "Pulmonology",
    "Endocrinology",
    "Urology",
    "Ophthalmology",
    "Ent",
    "Psychiatry",
    "Anesthesiology",
    "Pathology",
    "Emergency Medicine",
    "Family Medicine"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "Subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "Commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2022",
  "deployment_model": [
    "SaaS",
    "on_prem",
    "hybrid"
  ],
  "os_platforms": [
    "Web",
    "iOS",
    "Android",
    "Windows",
    "macOS",
    "Linux"
  ],
  "features": [
    "Automated appeal generation",
    "Medical necessity identification",
    "Unified submission to all payors",
    "Automated tracking and confirmation of receipt",
    "Immediate notifications of payor decisions",
    "Integration with legal and clinical guidelines",
    "AI-driven analysis of clinical documentation",
    "Support for small balance recovery",
    "Integration with CMS for electronic submission",
    "Integration with Cerner for enhanced appeal writing"
  ],
  "optional_modules": [
    "Medical coding",
    "Chart auditing"
  ],
  "integrations": [
    "CMS",
    "Cerner"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "yes",
  "system_requirements": "Major OS/DB/hardware needs, or empty if SaaS-only",
  "compliance": [
    "HIPAA",
    "GDPR",
    "HITECH",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "consent mgmt",
    "anonymization",
    "data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "EmpowerMe"
  ],
  "user_reviews": [
    "Using Apollo has enhanced our appeal team’s efficiency and streamlined our revenue cycle management tasks at hyperspeed.",
    "Partnering with Crosby Health and having access to Apollo has completely revamped our organization and saved us time and team bandwidth."
  ],
  "ratings": [
    "91.8% on medical license board exam questions, surpassing every other clinical LLM available today. ([alleywatch.com](https://alleywatch.com/2024/05/crosby-health-clinical-llm-appeals-claims-denial-automation-medical-coding-insurance-rishi-gowda/?utm_source=openai))"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2024",
  "integration_partners": [
    "Epic",
    "MEDITECH",
    "Cerner",
    "Net Health",
    "CMS",
    "UHC"
  ],
  "id": "SW1184",
  "slug": "clinical-appeals-automation",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/clinical-appeals-automation.json"
  }
}