Proof before purchase.
Inspect the clinical argument quality before you engage. Each specimen shows the actual deliverable format — the same output your team would receive.
These are fabricated scenarios with realistic clinical detail — not actual patient cases. They demonstrate the reasoning methodology, criteria mapping, and deliverable format. Proprietary criteria content has been generalized; actual deliverables reference the applicable licensed criteria framework as documented in the case record.
Medical Necessity Escalation Memo
The fixed 12-section physician memo — the standard desk deliverable. SNF admission denial after acute hospitalization.
View Specimen →DRG Downgrade Challenge
Sepsis DRG 872 → 871 recovery memo. Clinical severity evidence, point-by-point auditor rebuttal, CDI handoff.
View Specimen →Observation vs. Inpatient Defense
Retrospective observation downgrade — chest pain admission. Two-Midnight Rule prospective analysis with admission-time clinical-judgment documentation.
View Specimen →AI Appeal Clinical QA
Before/after physician review of an AI-drafted appeal. Annotated findings: hallucinated claims, weak logic, missing comorbidities, overstatement.
View Specimen →Peer-to-Peer Prep Brief
AFib catheter ablation PA denial. Criteria-mapped physician briefing with anticipated objections and prepared responses.
View Specimen →Pre-Denial Medical Necessity Dossier
Lumbar spinal fusion prior authorization. Physician-authored argument submitted before the payer decides — so the first answer is yes.
View Specimen →No-PHI Clinical Denial AR Audit
72-hour physician triage of a 47-case denial inventory. Recoverable AR, deadline risk, payer patterns, pursuit sequence. No PHI required.
View Specimen →NSA/IDR Clinical Value Dossier
Out-of-network emergency surgery. All six statutory additional circumstances, QPA analysis, clinical complexity narrative, market benchmarking.
View Specimen →Reviewed the specimens? Test the desk on your own cases.
Start with a 3-case pilot and receive the same memo format on your selected denials.