For clinicians and practices
Prior auth, denials, and appeals in one workflow — your patient's record, your physician's signature.
The PA-and-appeal burden often falls on the practice. ApprovalHelp organizes the governed payer-work case: patient context, prior authorization, denial, appeal stage, candidate or source-verified deadline, reviewed evidence, and outcome. Drafts can include applicable payer, regulatory, and clinical sources when verified; the clinician checks, edits, and signs every clinical assertion.
Start your ApprovalHelp account →Where the time goes
- Manual draft — typically 45–90 minutes per appeal: pulling the denial-letter facts, finding the relevant guideline citation, writing the medical-necessity argument, formatting for the insurer.
- ApprovalHelp draft — extracts candidate facts with provenance, organizes the reviewed evidence and source set, and prepares a draft for qualified verification, prescriber signature, and controlled filing. Deadlines remain candidate or verified with their source.
- What we do not do — replace your clinical judgment or claim the appeal will succeed. The letter is a tool, not a guarantee. SMART-on-FHIR and payer connections are offered only at the production, private-pilot, or sandbox status shown in the current integration register.
What's in the drafted letter
- Patient + plan facts pulled from the denial letter and your patient record (member ID, claim #, date of service, prior-auth #, etc.).
- Federal appeal-rights citation — ACA §2719, ERISA §503, NSA §2799A, 42 CFR 422 Subpart M, or 42 CFR 438 Subpart F, selected by the statutory appeal ladder for the patient's plan type.
- Insurer-specific coverage criteria — what the insurer's own policy says, point by point, with the appeal addressing each criterion. First-level letters are gated against human-reviewed insurer criteria.
- Authoritative clinical guideline citation — NCCN for oncology, ADA / AACE for endocrine, ACR for rheumatology, AHA / ACC for cardio, etc. The drafter picks the right body for the condition and the case.
- Anti-fabrication safeguards — extracted values carry source context and confidence, missing or conflicted facts are flagged, and deterministic checks block unsupported numeric or medication assertions from finalization. These controls reduce risk; they do not replace clinician verification.
Pricing
Plans start at $499/mo
Prior-authorization and appeal drafts are not billed per request on self-serve plans. Eligibility checks are billed separately.
See full ApprovalHelp pricing →Cancel anytime. Pricing is the same for every clinic regardless of how you found us.
Not ready to subscribe?
Hand patients a free ApprovalHelp card instead.
Print a sheet of patient-handout cards. Useful even if your practice never uses ApprovalHelp — every denied patient deserves to know they can appeal.
See the printable card →
ApprovalHelp drafts physician-ready prior-authorization and appeal documents; the treating clinician is the decision-maker, signs, and submits. We do not provide medical or legal advice. We do not guarantee that any given PA or appeal will be approved by the payer — outcomes depend on plan documents, the clinician's clinical narrative, and the insurer's decision. Pricing shown is in USD; subscriptions billed monthly via Stripe.