AI Agent-Powered
Denials Management
5 specialized AI agents on UiPath — predicting, routing, and resolving claim denials with HIPAA-compliant audit trails and a self-learning feedback loop.
0%
denial rate reduction
How it works
Claim denied
Payer returns denial
Agent
Intake & classification
Reads denial reason · tags EHR
Agent
Root cause analysis
ICD/CPT · prior auth · coding
Agent
Denial prediction
Flags future risk patterns
Agent
Eligibility & code
Payer rules · coverage check
Agent
Payer-specific appeals generation
Auto-drafts appeal · attaches clinical docs
Auto-resubmitted
Corrected claim sent
Appeal
route?
route?
Escalated
RCM staff review
Self-learning loop
Patterns fed back to AI
Revenue recovered + audit trail
HIPAA-compliant · logged in UiPath Orchestrator
AcceliHealth · UiPath Orchestrator + Maestro + EHR integration · HIPAA & IRDAI compliant
Use case: Multi-specialty medical group
A multi-specialty medical group was losing millions annually to reactive denial workflows — manual payer portal chasing, slow appeals drafting, and inconsistent coding. Accelirate deployed a multi-agent denial management system that predicts, routes, and resolves denials — proactively and at scale.
30%
Denial rate reduction
$4.2M
Denied claims recovered
25%
Cleaner claim submission
40%
Faster appeals processing
50%
Time & cost saved
Key outcomes
Denials predicted before submission — stops rejections at the source
Payer-specific appeal letters auto-drafted and attached with clinical docs
Self-learning loop continuously improves accuracy across payer rules
Human-in-the-loop for hard denials only — staff focus on high-value cases
Full HIPAA-compliant audit trail · integrates with existing EHR systems