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From: insurance-claims@provider.com
Subject: RE: Claim #INS-28772-B
10:24 AM
CLAIM DENIAL NOTICE
Claim #: INS-28772-B has been DENIED.
Reason: Insufficient documentation for line items 27-34.
Reason: Insufficient documentation for line items 27-34.
ASSESSMENT_REPORT_v3_final.pdfPAGE 1/16
| ITEM # | DESCRIPTION | QTY | UNIT PRICE | SUBTOTAL | STATUS |
|---|---|---|---|---|---|
| #24 | Water mitigation labor | 1 | $120.00 | $120.00 | DISPUTED |
| #25 | Water mitigation equipment | 2 | $135.00 | $270.00 | DISPUTED |
| #26 | Water mitigation materials | 3 | $150.00 | $450.00 | DISPUTED |
| #27 | Water mitigation labor | 4 | $165.00 | $660.00 | DISPUTED |
| #28 | Water mitigation materials | 5 | $180.00 | $900.00 | DISPUTED |
| #29 | Water mitigation equipment | 6 | $195.00 | $1170.00 | DISPUTED |
| #30 | Water mitigation labor | 7 | $210.00 | $1470.00 | DISPUTED |
| #31 | Water mitigation equipment | 8 | $225.00 | $1800.00 | DISPUTED |
Claim_Calculation_v5.xlsxSheet 3 of 7
Row 1
Row 2
Row 3
Row 4
Row 5
Col A
Requires Review
Pending
Pending
Pending
Pending
Col B
Pending
Pending
Pending
Requires Review
Requires Review
Col C
$214.75
$349.96
$79.09
$285.84
$236.56
Col D
=SUM(C1*D1)
=SUM(C2*D2)
=SUM(C3*D3)
=SUM(C4*D4)
=SUM(C5*D5)
Call adjuster again!!
Missing documentation!
Deadline: Friday
ID#7907055
ID#6975108
ID#4940475
ID#6633683
ID#8511758
ID#5710472
ID#467682
ID#9972415
ID#1425602
ID#7230814
FWD: RE: RE: RE: Claim Submission Issue (18 emails)
We regret to inform you that your claim submission (#INS-28772-B) requires additional paperwork before processing. Please note that your previous documentation was...
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Case Study
Restorations rebuttals Automation
A large Dallas-based restorations business specializing in water damage mitigation, fire damage repair, and mold remediation faced challenges with insurance claim processing and rebuttal management.
Challenges
- CEO spent 30% of time on rebuttals
- 2-3 month deal cycles
- Delayed revenue recognition
Solution
- Automated PDF comparison system
- AI-powered negotiation language
- Seamless workflow integration
Client observed a 5% increase in topline, while saving upto 15 hours per use case, and processes claims 90% faster.