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Module 4: Claims Submission & Denial Management AI

Clean Claims, Smart Appeals & Automated A/R Follow-Up

Duration: 6 hours · Level: Advanced · Lessons: 3

A claim denied is revenue at risk. Build agents that submit clean claims the first time, auto-appeal standard denials with clinical evidence, and work the A/R until every dollar is collected.

Prerequisites​

Learning outcomes

By the end of this module you will be able to:

  • Build a pre-submission claim scrubbing agent that catches edits before payer rejection
  • Automate standard denial appeals with clinical evidence retrieval
  • Design an A/R follow-up agent with payer-specific rule logic

Lessons in this module​

  1. H4.1 — Pre-Submission Claim Scrubbing: Stop Denials Before They Happen · 55 min
  2. H4.2 — Automated Denial Appeals: Clinical Evidence + Regulatory Citations · 60 min
  3. H4.3 — A/R Follow-Up Agents: Working Every Dollar · 50 min

👉 Start here: H4.1 — Pre-Submission Claim Scrubbing: Stop Denials Before They Happen