Use it internally.
Hand the recommendations to your existing billing or revenue-cycle team and work them yourselves.
Soft Appeals · complimentary denial review
Start with the denials. Not a sales pitch.
Soft Appeals begins with a complimentary review of 20 recent denied claims, so you can see what needs action before deciding whether to engage anyone for recovery work. Your assessment organizes the reviewed claims by recommended action, financial value, priority, known time sensitivity and additional information required. You keep it whether or not you continue.
First step · no patient information
Do not include patient names, dates of birth, medical record numbers, claim attachments, clinical records or other protected health information in the form below.
Patient-level information is requested only after the appropriate privacy documentation and secure intake process have been established. The form asks about your organization and your denial situation, nothing more.
No upload field, by design
No call required to begin
BAA before PHI
No obligation after the assessment
- 1 · Tell us about the denials
- → 2 · Secure intake
- → 3 · Review
- → 4 · Decide
What happens next
Five steps from inquiry to assessment.
01
Tell us about your organization
Complete the short form below using general business and denial information. No patient records are needed at this stage.
02
Soft Appeals reviews fit
We read what you sent to decide whether the claims and the scope you are describing suit the service. If more information is needed, we ask a business-level question rather than requesting records.
03
Establish the privacy and intake process
Where the review will involve protected health information, the applicable Business Associate Agreement and the secure information-sharing process are established before PHI is exchanged.
04
Provide the 20 denials securely
Once the intake process is ready, your organization receives instructions for providing the agreed claim and denial information through the designated channel.
05
Receive your Denial Recovery Assessment
Soft Appeals reviews the selected claims and returns a structured assessment showing recommended actions, financial value, priority, known time-sensitive items and information still required. Then you decide what happens next.
Start your review
Tell us about the denial situation.
Business-level information only. Every question below is answerable without opening a chart. If you are not sure of a number, an estimate is fine, and "not sure" is a real answer on most of these.
Soft Appeals denial review intake form
Do not send claims yet
The first form is deliberately free of patient information.
You may already have denial letters, explanations of benefits, remittance files, spreadsheets, screenshots or patient records ready to go. Keep them inside your existing approved environment until the Soft Appeals intake process is established. Once it is, you will be told exactly what is needed and how to provide it.
Not in this form
- Patient names
- Dates of birth
- Medical record numbers
- Member or subscriber identifiers
- Claim attachments
- Clinical records
- Denial letters carrying patient information
- Screenshots carrying patient information
- Explanations of benefits or remittance documents at patient level
- Any other protected health information
What we will ask for later
Not everything in the chart.
Once the agreements and the secure intake process are in place, the information needed for the 20-denial review may include the following. If something is missing, Soft Appeals identifies what it is and why it is needed rather than asking for a folder.
01
Claim and denial information
Enough to understand what was billed, what was denied and the payer's stated reason.
02
Remittance or denial information
The relevant denial codes, explanations, correspondence or payment information.
03
Submission information
Acknowledgement, filing or other claim-submission evidence where it is relevant.
04
Supporting information
Only the documentation reasonably needed to understand or evaluate the selected claim.
What you do not need to provide
Starting should not require handing over your whole system.
By default, the complimentary review does not require:
- unrestricted EHR access
- your entire patient database
- administrator credentials
- shared staff passwords
- unrelated clinical records
- every denial in your organization
- a perfectly organized denial report
Start with the agreed 20 claims. Expand when there is a reason to.
What your assessment includes
Every reviewed claim comes back with a decision attached.
01
Recommended action
Correct and resubmit, appeal, investigate, or close and deprioritize.
02
Financial value
The denied amount associated with the reviewed claim.
03
Priority
Which claims warrant earlier attention, based on the information available.
04
Timing
Known time-sensitive items, and the deadlines that need confirming.
05
Recommendation basis
Why the claim received the next action it did.
06
Information needed
What is missing before the claim can move.
07
Ownership
Whether the next action belongs with Soft Appeals, your organization, your billing partner or another party.
After the assessment
You are not automatically enrolled in anything.
Ask Soft Appeals to pursue selected claims.
If you want recovery support, the eligible scope, responsibilities, pricing, approval process and engagement terms are established first.
Provide additional information.
Claims marked Investigate can move forward once the missing information is obtained.
Take no further action.
The assessment stays yours. There is no obligation to continue.
If you already have a billing company
Bring them into the process.
Soft Appeals is not designed to work around your billing partner. If your billing company currently owns the denial workflow, you can involve the appropriate representative in the assessment and in any recovery work that follows.
Clear roles beat duplicate effort. A claim should have one visible next action and one accountable owner, and agreeing that up front is faster than discovering two people worked the same appeal.
If you have more than 20 denials
Start with a representative set.
You do not need to send an entire backlog to find out whether the service is useful. Begin with 20 recent denials. A larger backlog can be scoped after the initial review.
A sample of 20 is usually enough to establish:
- what kinds of problems are present
- which recovery paths appear most often
- whether additional recovery capacity would help
- what information is missing
- whether a larger engagement makes sense
If your denials are time-sensitive
Say so in the form, before sending anything.
Use the time-sensitive question in the intake form to flag that some claims may have approaching deadlines. Do not put patient information in the form to make the point. Soft Appeals can then decide the appropriate next intake step and whether the review can be responsibly accepted, based on the available information and current capacity.
An approaching deadline does not guarantee that a claim can be accepted, or that a complete submission can be prepared without the required information.
Fit
Worth knowing before you fill anything in.
Soft Appeals may be a fit when
The billing operation works, and denials still sit.
- You already have a billing operation.
- But denied claims still go unresolved.
- Staff know the backlog exists.
- Nobody has dedicated capacity to work it consistently.
- You want to know what deserves attention before paying for recovery work.
- The complimentary assessment is that starting point.
- You want recovery capacity without replacing your billing team.
- Soft Appeals works the denied claims you assign it.
- You want claim-level visibility.
- What is happening, who owns the next action, what is blocking it, how it resolved.
Soft Appeals may not be a fit when
The need sits outside denied-claim recovery.
- You need a full billing-company replacement.
- The service covers denied-claim recovery, not the whole revenue cycle.
- You need independent clinical decisions.
- Clinical judgment stays with the appropriate licensed or authorized professional.
- You need independent coding decisions or a coding audit.
- Coding issues are identified, but qualified coding review sits outside the standard scope unless separately established.
- You are seeking legal representation.
- Soft Appeals does not provide legal representation or legal advice.
- You want guaranteed payer outcomes.
- Recovery cannot be guaranteed by anyone who is being honest with you.
- The volume exceeds current responsible capacity.
- Soft Appeals may recommend a narrower scope rather than accepting work it cannot manage properly.
Before you submit
Five things to know.
- Do not include patient information in the intake form.
- The first 20-denial assessment is complimentary.
- The assessment does not obligate you to buy recovery services.
- Nothing is submitted to a payer through this form.
- Paid recovery work begins only after scope and engagement terms are established.
Ready?
Begin without sending patient information.
Tell us about your organization and your denial situation first. If Soft Appeals looks appropriate, the next intake step gets established before any claim-level information is exchanged. Already have security, compliance or contracting questions? Ask those before sending PHI, not after.