PriorAuthPro

Turn your denial letter into
a complete appeal packet

Upload your insurance denial letter and get a professional, structured appeal packet in minutes. PriorAuthPro analyzes the denial, identifies the category and insurer rules, and generates documents tailored to your specific situation.

Insurance companies count on you not appealing

Prior authorization denials are common, and most patients don't know they can fight back. The appeal process is confusing, time-sensitive, and designed in a way that discourages follow-through. PriorAuthPro changes that equation.

Denials are routine

Insurance companies deny prior authorizations at significant rates. Many of those denials are reversed on appeal, but only if you actually file one. Most patients don't.

The clock is ticking

Appeal deadlines vary by insurer and state. Some give you 180 days. Others give you 30. Missing the window means the denial stands regardless of merit.

The paperwork is overwhelming

A strong appeal needs specific language, proper clinical framing, supporting documentation, and compliance with the insurer's submission requirements. Most patients don't know where to start.

Three steps from denial to appeal

1. Upload your denial letter

Paste the text directly, upload a PDF, snap a photo, or upload a Word document. PriorAuthPro's AI reads the full letter and extracts the insurer, denial reason, treatment details, deadlines, and patient information.

2. Review and fill in details

The system classifies the denial and pre-fills what it can. You review the analysis, confirm the details, and add any information the letter didn't include (diagnosis, treatment history, provider information).

3. Download your appeal packet

Get two professional Word documents: a Submission Packet ready to send to your insurer and a Builder Workbook with your internal prep materials, deadline tracking, and escalation instructions.

Two documents built for your situation

Every packet is tailored to the specific denial category, insurer, and state. No generic templates.

Submission Packet

What you send to the insurer

The insurer-facing document includes an appeal cover letter with proper clinical language, a care timeline showing treatment history, a clinical summary establishing medical necessity, policy criteria mapping, a letter of medical necessity template for your provider, and an evidence exhibit list.

Builder Workbook

Your internal prep materials

The workbook includes an evidence checklist (what to gather and where to get it), step-by-step submission instructions for your insurer, a deadline worksheet with key dates, an escalation overview with state-specific external review paths, and pre-export validation warnings flagging anything that needs attention.

Five denial categories. Ten insurers. Twenty-two states.

PriorAuthPro classifies every denial and tailors the appeal accordingly. Each category gets a different strategy, different language, and different supporting evidence requirements.

Procedural

Authorization not on file, untimely request, wrong process, administrative error. The appeal focuses on correcting the procedural issue and documenting proper authorization.

Medical necessity

Insurer says the treatment is not clinically indicated. The appeal builds a clinical case with evidence, guidelines, and provider attestation.

Benefit exclusion

Service not covered under plan terms. The appeal examines coverage language, identifies potential misapplication, and builds arguments for coverage.

Coding / billing error

CPT/ICD mismatch, incorrect procedure code, bundling issue. The appeal identifies the coding error and provides corrected information.

Documentation insufficiency

Insurer says submitted records were incomplete. The appeal identifies what's missing and helps you compile and resubmit the required documentation.

Insurer-specific rules and deadlines

PriorAuthPro maintains a database of insurer-specific appeal requirements, updated weekly. When your insurer is in the database, you get exact deadlines, fax numbers, submission addresses, and required documentation lists.

Aetna

BCBS

UnitedHealthcare

Cigna Healthcare

Humana

Anthem / Elevance

Kaiser Permanente

Centene / Ambetter

Molina Healthcare

Health Net

Insurers not in the database are fully supported. PriorAuthPro generates complete packets using AI analysis and instructs you to reference your denial letter for submission details.

$59 per appeal packet

One price. Complete packet. No subscription, no recurring charges, no hidden fees. Pay when you need it, and get your documents in minutes.