Turn Denied Claims Into Payer-Ready Appeal Files

Swivel helps billing teams and clinicians respond to medical-necessity, prior-auth, and documentation denials with the right clinical evidence, payer policy references, and appeal narrative — in under 60 seconds.

🔒 HIPAA-ready workflow  |  BAA available  |  No EMR integration required

$262B
In claims denied annually across U.S. healthcare
65%
Of denied claims are never resubmitted
54%
Of appealed claims are overturned — Premier Inc.

The average specialty practice writes off $70,000–$140,000 in denied claims every year.
With Swivel, that doesn't have to be you.

From Denied Claim To Appeal Letter In Under 60 Seconds

Every step is designed to save you time and maximize overturn rates.

Step 1

Pattern Recognition Built In

Enter the denial code, payer, and procedure - or snap a photo of the denial with your phone to upload automatically. Our system instantly recognizes the pattern and begins building your appeal strategy.

Denial CodeCO-50
PayerAetna
SpecialtyOncology
ProcedurePembrolizumab
Pattern matched: 73% overturn rate for CO-50 + Aetna + Oncology
Step 2

We Tell You Exactly What to Pull

No guessing what documentation to include. Our system generates a ranked checklist based on the specific denial code and payer - with critical items flagged first.

PD-L1 expression resultsCritical
Tumor staging documentationCritical
Prior therapy historyImportant
Pathology reportImportant
Treatment rationale noteSupporting
Payer insight: Aetna requires PD-L1 >= 1% for first-line approval
Step 3

From Shorthand to Structured Prose

Paste your clinical notes as-is — abbreviations, shorthand, all of it. Our engine structures the narrative using strict medical terminology, citing verified peer-reviewed evidence and national guidelines (like NCCN or ACNS). Swivel never hallucinates clinical facts — it only leverages the data you provide.

Your Input

pt w/ stage IIIB NSCLC, PD-L1 80%, failed carbo/pem, now prog on doce. Pembro appropriate per NCCN. Med nec clearly established.

Swivel Output

The patient is a [age]-year-old [sex] diagnosed with Stage IIIB non-small cell lung cancer (NSCLC) with a PD-L1 tumor proportion score of 80%. The patient has progressed through two prior lines of systemic therapy...

Step 4

Ready to Print and Send

A complete, formatted appeal letter citing the specific payer policy, clinical guidelines, and peer-reviewed evidence. Export to PDF, Word, or copy-paste directly into your clearinghouse portal. Includes overturn rate data and deadline tracking.

Appeal Letter - Generated

Re: Appeal of Denied Claim - CO-50

Aetna Medical Director | Pembrolizumab

Dear Medical Director, I am writing to formally appeal the denial of coverage for pembrolizumab (Keytruda) under claim [#]. This denial under code CO-50 is inconsistent with the patient's documented clinical presentation and current NCCN guidelines...

73% overturn rate
Deadline: 42 days remaining

Calculate Your Practice's Recovery Potential

Adjust the sliders to match your practice. We'll show you what's recoverable.

Denied claims per month20
5100
Average denied claim value$1,000
$500$10,000

Not sure? Primary care claims typically range from $150-$500. Specialty claims (orthopedic, cardiology, imaging) typically range from $1,000-$5,000+.

Revenue At Stake / Year
$240,000
Est. Recovered / Month
$13,000
Est. Recovered / Year
$156,000
Estimated ROI
21.7×
vs $599 / mo on the Growth plan
Plan Recommendation Based on Your Metrics: Growth

All numbers above are modeled based on your assumptions. Actual recovery varies by practice, insurer, and case strength. Swivel does not guarantee approval of any specific response. We help you respond faster, more consistently, and with stronger structure so revenue isn't written off without an attempt.

Choose Your Plan

Cancel anytime. No commissions. No revenue share.

How many denials does your practice get per month?

Essential

15 denial response files / month

$299 /mo
Potential Recovery
$10,000/mo
15 appeals × avg $1,025 claim × 65% overturn rate
~33× return on plan cost
  • 15 denial response files per month
  • 1 practitioner seat
  • Payer-specific appeals
  • Clinical evidence citations
  • Evidence checklists
  • Deadline tracking
  • 1-click denial upload
Start 7-Day Free Trial
Most Popular

Growth

50 denial response files / month

$599 /mo
Potential Recovery
$33,000/mo
50 appeals × avg $1,025 claim × 65% overturn rate
~55× return on plan cost
  • 50 denial response files per month
  • Up to 5 practitioner seats
  • Payer-specific appeals
  • Clinical evidence citations
  • Evidence checklists
  • Deadline tracking
  • 1-click denial upload
Start 7-Day Free Trial

Scale

150 denial response files / month

$1,199 /mo
Potential Recovery
$65,000+/mo
150 appeals × avg $1,025 claim × 65% overturn rate
~54× return on plan cost
  • 150 denial response files per month
  • Up to 10 practitioner seats
  • Payer-specific appeals
  • Clinical evidence citations
  • Evidence checklists
  • Deadline tracking
  • 1-click denial upload
Start 7-Day Free Trial

Common Questions

Our projections use industry denial and appeal data from KFF, HHS OIG, and MDaudit's 2025 Benchmark Report. Actual recovery depends on your payer mix, specialty, denial types, and how thoroughly each denial is worked. We default to conservative assumptions in the calculator.

At $1,000 per denial and 20 denials per month, that's $20,000 in denied revenue sitting in A/R. Even a 35% structured recovery rate returns $7,000/month — $84,000/year. Our Essential plan costs $299/month. The ROI case is straightforward.

Your first denial response file is ready in under 60 seconds. Most payers respond to appeals within 30-45 days. Practices typically see their first overturned denial within 4-6 weeks of starting.

Time. The average manual appeal takes 45-60 minutes of staff time per claim. Most practices don't have the bandwidth to write individualized, evidence-backed responses for every denial. Swivel reduces that to under 5 minutes per denial.

Swivel generates denial response files for the most common denial categories including medical necessity (CO-50), prior authorization, coding disputes, timely filing, bundling/unbundling, and more. We cover denials across all major CPT code families and specialties.

All major commercial payers including UnitedHealthcare, Aetna, Cigna, Blue Cross Blue Shield, Humana, and Medicare Advantage plans. Our system tailors each response to the specific payer's policies and appeal requirements.

No. Your file allowance resets at the beginning of each billing cycle. Unused files do not carry over. We recommend choosing the plan that matches your typical monthly denial volume.

Per practice. Every plan covers your entire practice at one flat rate — no per-physician fees, no hidden charges.

No. You keep 100% of every dollar you recover. Our pricing is a simple monthly subscription with no commissions, no revenue share, and no surprise fees.

Yes. There is no long-term contract. You can cancel your subscription at any time from your account settings. You'll retain access through the end of your current billing period.

Swivel operates as a standalone, secure web application — and that's intentional. There's zero IT implementation time, no approval process, and no waiting on your EMR vendor. Your staff simply pastes clinical notes or uploads the denial letter and starts generating responses immediately. No complex integration required means your practice can start recovering revenue in 5 minutes, not 5 months.

Your First Recovered Denial Pays for Months of Swivel.

Start your free trial. No commissions. No revenue share. No commitments. Cancel anytime.