Medicare Advantage · downcoding defense · launching soon
Show the receipts on payer downcoding.
Receipts reads your 835 remittance files, finds every visit your Medicare Advantage payer quietly downgraded, and drafts the appeal letters. You mail the packet. Most clinics never file these — so we're building the tool that does it for them.
RE: Appeal of claim adjustment · Remit 2026-0417
Notice of Improper E/M Downcoding
To the Provider Appeals Department: this claim was billed and documented at 99214 but adjudicated at 99213. The medical record supports the level billed under the 2021 AMA E/M guidelines.
- Billed CPT 99214
- $172.00
- Paid as CPT 99213
- $118.00
- Amount in dispute
- + $54.00
CMS Pub. 100-04, Ch. 12 §30.6.1 — payment must reflect the service documented, not a default lower level. AMA CPT E/M, MDM table.
READY TO MAIL- DE-IDENTIFY
- Patient identifiers are stripped before anything reaches the model. No PHI ever leaves for analysis.
- DELETE 24h
- Your raw 835 files are destroyed within 24 hours of processing — guaranteed, not a setting.
- BAA FIRST
- A per-engagement, limited-purpose Business Associate Agreement is signed before any upload.
How it works
Three steps. Two minutes of your time.
Send 30 days of 835s
Upload through a signed, single-use link after the BAA is signed. We never ask for your portal login.
We detect and draft
Our rules flag every downcoded E/M visit. We draft an appeal letter for each, citing the exact CMS and AMA standard — no boilerplate, no hallucinated citations.
You get a packet to mail
A PDF report of every downcoded claim plus print-ready appeal letters on your letterhead. Sign and send.
Free first analysis at launch
When we open, you'll send 30 days of 835s and get back a PDF report of every downcoded claim plus a packet of pre-drafted appeal letters to mail. The first run is free — join the waitlist to go first.
Join the waitlistThe Downcoding Index
A quarterly, de-identified ranking of which Medicare Advantage payers downcode the most. No spam, unsubscribe anytime.
See the current ranking →We process your 835 file under a per-engagement limited-purpose BAA. Raw files are deleted within 24 hours of processing. Only de-identified aggregate statistics are retained beyond that window.