65%
Denied Claims Left Unreworked — The Revenue Gap the AI Denial Management Agent Closes.
AI Denial Management Agent
Denial management software that classifies every 835 ERA, drafts payer-specific appeals, and prevents denials with upstream feedback loops.
Book Your Free Demo
See it working on your own workflows. We reply within 24 hours.
Trusted by startups and global leaders
Six Capabilities of the AI Denial Management Agent
From real-time 835 ERA intake and CARC/RARC classification to AI-drafted appeals, priority worklist management, payer compliance monitoring, and prevention feedback loops — these six capability pillars cover every dimension of claim denial recovery and prevention.
Automated 835 ERA Denial Intake & CARC/RARC Classification
Real-time ingestion of 835 ERA transactions from Availity, Waystar, and Change Healthcare — every denied claim parsed for CARC/RARC codes and routed into the denial taxonomy within seconds.
AI Root Cause Analysis & Systemic Pattern Detection
ML analysis across every denied claim — by payer, provider, CPT/HCPCS code, and diagnosis — surfacing denial patterns that signal structural failures, not one-off errors.
Intelligent Appeal Drafting & Payer Submission
AI drafts complete appeal packages for every denial type — clinical justification letters against MCG/InterQual criteria, administrative appeals for eligibility and timely filing, and coding dispute letters citing AHA guidance.
Priority-Ranked Denial Worklist & Deadline Management
AI scores every denial on financial value, appeal win probability, and deadline urgency — putting the highest-priority claims at the top of every biller's worklist automatically.
Payer Behaviour Monitoring & Contract Compliance
Every paid claim cross-referenced against the contracted fee schedule — identifying line-item underpayments by payer, service type, and date. HFMA estimates 1–3% of net patient revenue is lost annually to undetected underpayments.
Prevention Feedback Loop & Upstream Process Correction
Every classified denial routes upstream as a prevention action — eligibility failures trigger a patient access review, auth denials a PA gap analysis, and coding denials deliver provider-specific CPT feedback.
85%
Denied Claims Left Unreworked — The Revenue Gap the AI Denial Management Agent Closes.
AI Denial Management Agent
65% of denied claims are written off without a rework attempt — not because recovery is impossible, but because manual teams cannot sustain the volume at $118 per rework.
Get Your Denial Impact Assessment
$19.7 Billion Fighting Denials. 90% of Them Preventable.
Every number comes from production revenue-cycle deployments — measured live, not projected in a pitch deck.
90%
of healthcare claim denials are preventable — caused by eligibility failures, missing authorisations, coding errors, and documentation gaps that AI catches…
100+
Enterprise customers trusting Bonami X AI for mission-critical healthcare and revenue cycle operations.
24/7
Autonomous monitoring with real-time alerts — continuous automated intervention across every workflow.
Our Process
Why Revenue Cycle Leaders Deploy Bonami's AI Denial Management Agent
Drag, click, or use the dots to walk through each reason.
90% of Denials Are Preventable — AI Closes the Prevention Gap That Manual Teams Cannot
90% of denials are preventable. The AI agent routes every classified denial upstream as a prevention action within hours — closing the loop manual teams cannot.
63% of Denials Are Recoverable If Appealed — AI Ensures Every Recoverable Denial Is Worked
63% of denied claims are recoverable, yet 65% are never reworked. The AI agent appeals every recoverable denial before its deadline — regardless of dollar amount.
Denial Data Drives Payer Contract Negotiation — Not Just Operational Rework
Denial data is more than rework. The AI agent aggregates denial patterns and underpayment data into claim-level evidence for payer contract renegotiation.
Works With Your Existing Revenue Cycle & EHR Stack
The AI Denial Management Agent connects to your EHR, clearinghouses, practice management system, and payer networks via ANSI X12 835, FHIR R4, and REST APIs — reading remittance data, accessing clinical documentation for appeal drafting, and writing appeal status back to your existing systems.
Epic
Oracle Health
athenahealth
Waystar
Change Healthcare / Optum
Availity
Experian Health
From the Desk of Our Esteemed Clients
Real results from enterprises that have deployed Bonami's AI solutions across industries.
Bonami's AI platform revolutionized our content creation process. Their natural language generation tools helped us scale our content production by 300% while maintaining exceptional quality and brand voice.
85%
Stop Writing Off 65% of Denied Claims Your Revenue Cycle Could Be Recovering
Every denial that is not worked is revenue your organisation earned and billed — but will not collect.
Book a Denial Recovery AI Demo
Six Capabilities of the AI Denial Management Agent
From real-time 835 ERA intake and CARC/RARC classification to AI-drafted appeals, priority worklist management, payer compliance monitoring, and prevention feedback loops — these six capability pillars cover every…
01
Automated 835 ERA Denial Intake
Real-time ingestion of 835 ERA transactions from Availity, Waystar, and Change Healthcare — every denied claim parsed for CARC/RARC codes and routed into the denial taxonomy within seconds.
02
AI Root Cause Analysis
ML analysis across every denied claim — by payer, provider, CPT/HCPCS code, and diagnosis — surfacing denial patterns that signal structural failures, not one-off errors.
03
Intelligent Appeal Drafting
AI drafts complete appeal packages for every denial type — clinical justification letters against MCG/InterQual criteria, administrative appeals for eligibility and timely filing, and coding dispute letters citing AHA guidance.
04
Priority-Ranked Denial Worklist
AI scores every denial on financial value, appeal win probability, and deadline urgency — putting the highest-priority claims at the top of every biller's worklist automatically.
05
Payer Behaviour Monitoring
Every paid claim cross-referenced against the contracted fee schedule — identifying line-item underpayments by payer, service type, and date. HFMA estimates 1–3% of net patient revenue is lost annually to undetected underpayments.
06
Prevention Feedback Loop
Every classified denial routes upstream as a prevention action — eligibility failures trigger a patient access review, auth denials a PA gap analysis, and coding denials deliver provider-specific CPT feedback.
Get in touch
Ready to Stop Writing Off Recoverable Denied Revenue?
Talk to a revenue cycle AI specialist — get a live demo of the Denial Management Agent running against your actual 835 ERA data and payer mix, plus a denial recovery impact assessment showing what your current rework gap is costing each month.
Response within 24 hours
Your data is protected & secure
Free consultation, no obligation
Frequently Asked Questions
[ 1 ]
What is an AI Denial Management Agent?
An AI Denial Management Agent autonomously reads every ANSI X12 835 ERA, classifies each denial by CARC/RARC root cause, scores it by appeal win probability and financial value, drafts a payer-specific appeal package from EHR clinical data, and routes prevention signals upstream to close the loop on recurring denial categories.
[ 2 ]
How does AI denial management reduce the denial write-off rate?
The 65% write-off rate exists because building a medical necessity appeal manually takes 45–90 minutes per denial. The AI agent completes the same process in minutes — retrieving EHR clinical data via FHIR API, mapping it against clinical criteria, and drafting the complete payer-specific appeal.
[ 3 ]
What types of claim denials does the agent manage?
The agent handles all CARC/RARC denial categories: eligibility and coverage, authorisation and referral, medical necessity, coding and unbundling, timely filing, duplicate claims, coordination of benefits, and patient responsibility.
[ 4 ]
How does the agent draft clinical appeal letters?
For clinical denials, the agent accesses the patient's EHR via FHIR R4 API — retrieving clinical notes, diagnostic results, and medication history — and maps the relevant data against MCG Health or InterQual criteria for the denied service type.
[ 5 ]
Which EHR and RCM platforms does the agent integrate with?
The agent integrates with Epic (FHIR R4 clinical APIs), Oracle Health Cerner (Millennium REST and FHIR R4), and athenahealth (athenaOne REST API) for clinical data access.
[ 6 ]
How does the agent detect underpayments?
Underpayment detection runs on every paid claim — cross-referencing the amount paid against the contracted fee schedule for the specific payer, service code, place of service, and date of service.
[ 7 ]
How does the agent support payer contract negotiation?
The agent builds a structured payer analytics environment for managed care contracting: denial rates per payer benchmarked against MGMA/HFMA standards, appeal overturn rates documenting systematic over-denial, underpayment recovery amounts, and denial trend data across the contract period.
[ 8 ]
How long does implementation take and what revenue impact can we expect?
Standard production deployment runs 4–6 weeks: clearinghouse 835 feeds, EHR FHIR API connections, payer fee schedules loaded, and appeal template library configured for the top 15 payers by volume.
Global presence