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insurance-intel module

Get paid faster. Fight every denial.

Real-time eligibility before every appointment, electronic claims that go out clean, ERA remittances posted automatically, and AI that drafts your denial appeals.

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demo@upgpt.ai

DemoAudit2026!

94% first-pass claim acceptance rateERA auto-posted in < 2 minutesAR days reduced 42 → 28

Everything in this module

Real-Time Eligibility

Verify Delta, Cigna, MetLife, Aetna, and 900+ carriers in seconds before every appointment.

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📤

Electronic Claims (EDI 837)

Submit clean claims electronically to every major payer. AI scrubs for code conflicts before sending.

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💰

ERA Auto-Posting (EDI 835)

Remittances parsed and posted to the ledger automatically. Zero manual entry.

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🏦

Denial Intelligence

Tracks denial patterns by payer and CDT code. AI drafts appeal letters ready for your signature.

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📋

Prior Auth Automation

Submit and track prior authorizations with payer-specific CDT rules applied automatically.

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🔬

CDT Rule Engine

Carrier-specific code rules prevent unbundling violations, frequency limit errors, and coverage mismatches before submission.

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📊

AR Worklist

Prioritized follow-up list ranked by balance age, payer, and recovery probability.

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🏅

Credentialing Alerts

Get notified before a provider credential or plan participation lapses.

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Insurance Intel · EDI 837/835 · 900+ carriers · BAA included

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