Denied ≠ done.
Most denied claims are never reworked — the appeal is a paperwork grind your front desk never gets to, and the claim quietly ages past the filing deadline. AppealNest reads the denial, matches your clinical evidence, and drafts the payer-formatted appeal, so your team just reviews, signs, and sends.
Flat from $149/mo · unlimited claims · no card for the trial · your team signs every appeal
D4341 · Periodontal scaling & root planing (per quadrant)
CARC 50 · RARC N115“Denied — periodontal charting on file does not support the severity billed; pocket depths of 5 mm or greater are not documented for the treated quadrant.”
Appealable. Attach the periodontal charting showing pocket depths ≥5 mm and the radiographic bone loss for the treated quadrant; cite the AAP staging that supports SRP.
Enclosed periodontal charting dated 03/14 documents pocket depths of 5–7 mm at #18–#20 with generalized bleeding on probing, and the bitewing series shows crestal bone loss consistent with Stage II periodontitis — meeting the documentation standard for D4341 in the treated quadrant.
of dental claims are denied — mostly on administrative and documentation grounds, not clinical ones
of denied claims are never reworked by the provider — pure write-off, most past the deadline
of appeals succeed when filed with proper documentation — the ones that actually get filed
From denial to signed appeal in three steps
You know the money's recoverable — you just never have the hour it takes to write the appeal before the deadline. That's the whole job AppealNest does.
Upload the denial + your chart note
Drop in the scanned EOB (or the ERA 835 straight from your clearinghouse) and the matching clinical documentation — chart note, perio chart, radiograph. We read the denial and pull the claim details for you.
AI classifies the denial & drafts the appeal
The pipeline reads every denied line, classifies the CARC/RARC reason, checks your evidence against what the payer requires, and drafts a payer-formatted appeal letter — quoting only what's actually in your uploaded notes.
Review, sign, and send before the deadline
Your team accepts, edits, or rejects each section, sees any missing-evidence warnings, then finalizes a letter PDF, attachment checklist, and cover email — ready to submit through your existing channel.
See what's aging out — before it does
Every claim carries its own appeal deadline, computed from the payer and the denial date. AppealNest sorts your board by time-to-deadline, so the claims about to expire are the ones you see first. No more denials silently aging past timely filing.
- Red when a claim has under a week left
- Amber inside three weeks — time to act
- A running total of dollars at stake across expiring claims
The denials that fall through
Our knowledge base maps the common CARC/RARC reasons and payer language to an appeal strategy and the exact evidence each one needs — across both dental and optometry.
Perio charting / pocket depths don't support the SRP billed
Crown, build-up, or exam denied as too soon or alternate-benefited
Optometry 92250 / 92134 imaging without the documented reason
Bundled into the wrong benefit lane — vision vs medical
Optometry claim sent to the plan that never covers it
The claim quietly aging toward the appeal deadline
A separately payable procedure denied as included
Coverage-lapse and coordination-of-benefits denials
What the appeal grind costs you today
The math the billing services would rather you not run.
A flat retainer under a collections threshold, then a percentage of everything you collect — forever, scaling as you grow.
- — A cut of every dollar, on every claim
- — You hand off the file and wait
- — Or you write the denial off and lose it entirely
A flat monthly price for the appeal work — a fraction of a billing retainer, and never a percentage of what you collect.
- Flat price — never a cut of your collections
- Rework every denial, not just the big ones
- Your team keeps the file and signs every appeal
- HIPAA-supported: BAAs, encryption, audit trail
Straight answers
Do payers actually accept these appeals?
A well-documented appeal — the denial reason addressed, the required clinical evidence attached, on the payer's expected format — is standard practice. Appeals filed with proper documentation succeed roughly 60–70% of the time; the reason recovery is missed is that most denials are simply never reworked. AppealNest produces exactly that documented appeal — your staff reviews and signs it under the practice's name.
Will the AI make up clinical facts?
No. Drafting is grounded in the documents you upload — the letter quotes your actual chart note and charting, never invented findings. If a required piece of evidence is missing, AppealNest flags it as a to-do instead of writing around it. Your licensed staff reviews and signs every appeal; we never submit one automatically.
Is it really flat pricing?
One flat monthly price per location, unlimited claims. Never a percentage of your collections, never a per-claim fee. A full-service billing service runs about $1,400 a month or a cut of everything you collect — AppealNest handles the appeal grind for a fraction of that, and your team keeps control.
Stop writing off denials.
Upload one denied claim and its chart note, and watch the appeal draft itself — classified, cited to your own documents, and ready for your team to sign before the deadline.
No credit card for the trial · cancel anytime · your team signs every appeal