Best Denials & Appeals Management Products

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

• Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
• Patient Access Insights (PAI) – Enhances financial experience pre-service
• Revenue Integrity Suite (RI) – Reduces denials and compliance risks
• Productivity Analytics (PA) – Improves staff productivity in real-time
• Cost Insights (CI) – Targets controllable costs
• Business Office Suite (BOS) – Unifies patient accounting data

Patients placed in the wrong bed status with improper documentation results in massive revenue loss and patient dissatisfaction.

Physicians can’t keep up with constantly changing criteria needed to admit patients to the hospital, and hospitals spend tons of money and resources fixing bed status issues retrospectively.

AdmissionCare provides the admitting physician with automated admission criteria - such as MCG - integrated directly into the EHR workflow to help document medical necessity that increases payer reimbursements and reduce denials.

How does it work?

• Integrate into the clinician's EHR workflow
• Determine the most appropriate bed status for each patient at admission
• Synchronize payer criteria with the clinician's documentation
• Collect revenue for the care provided, while avoiding costly denials

Agentic AI employees for healthcare

Explore our custom AI employees for critical back office, revenue cycle, and administrative healthcare workflows. Some of our most popular include full automations for:

1. Prior authorizations
2. Claims processing
3. Insurance verification
4. Payment posting
5. Patient enrollment
6. Denial management
7. Claim scrubbing
8. Credentialing
9. Charge reconciliation

How Magical works

Fully automate rev cycle workflows

Use an AI employee trained specifically in revenue cycle management to automate entire processes end-to-end. (No human oversight required.)

Lower your cost to collect

Unlock the efficiency of a machine. Magical pulls patient patient data directly from one system into another, to minimize insurance denials and delays.

Built for enterprise security

Maintain the highest levels of security and privacy. We never store any personal health info on our servers. 

Daily Automated Testing | Automation Logs | SOC2 & HIPAA Compliant

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for the following reasons:

1. Fast: 1 month average implementation time
2. Reliable: 90%+ average success rate end-to-end
3. Proven: 100% agentic automation (no bots)
4. Scalable: Magical runs entirely on virtual machines
5. Interoperable: Magical can rapidly integrate with any system
6. Compliant: Magical is SOC 2 and HIPAA-compliant

Denials Resolution is a service handled by our Account Resolution Department. This department reviews EOB's and provides any required information to the payer, whether it's clinical denials, technical denials, or appeals. Once deemed valid, our representative will determine, based on client contract with the payer, if the balance is due from the patient or if the balance must be adjusted.

No two denials are the same, and your team needs to submit appeals quickly and efficiently. Our technology automatically identifies denials that can realistically be overturned, prioritizes them based on predicted cash value, and populates payer-specific appeal forms. Denial + Appeal Management from Waystar offers:

• Disruption-free implementation
• Customized, exception-based workflows
• Robust reporting and analytics to help make process improvements
• An Appeal Wizard that integrates into your PM or EMR system
• Payer scorecards to help guide more favorable contract negotiations

Processing insurance claims can be a labor-intensive task, involving extensive documentation, data entry, and manual effort. CampTek has an Intelligent Automation solution will do the following things:

• The integration of AI identifies problematic payors and claim types. These types of issues can be remediated via System configurations or through automation.   
• Larger more repetitive workflows can also be automated at scale.  
• This an end-to-end solution can be implemented to solve the issues with a claim before it is submitted but also as a continuous improvement of workflows.  

Automated Data Extraction and Transmission:

It will automate the extraction and transmission of data related to the insurance claim in any EHR/EMR, payor portal and clearing house. 

Unstructured data, such as handwritten notes or scanned documents, can be automatically extracted and organized and entered into an EMR/EHR, ERP System, payor portal or clearing house website. It’s accurate and consistent.  

Average Annual KPI’s for a Provider with $3B Annual Net Patient Revenue:

• Efficiency and accuracy increased by 48% 
• Accelerates reimbursement by 38% 
• Reduces rework and denials by 30%