$262B in claims are denied every year (CMS). 75%+ are overturnable on appeal (KFF). Fewer than 2% ever get one filed.

Most platforms react to denials. CoverageUnlocked reverse-engineers why payers deny, so the claim gets fixed before it goes out. When one slips through, the appeal carries a named pattern and the regulatory leverage to win.

Big Ticket Blocker. Clinical Evidence Starvation. Ticking Clock. These are named payer behavior patterns from our graph — 24+ payers annotated with insider context built over 20 years inside the industry. None of it lives in public data.

For health systems: $2–4M a year in recoverable revenue for 200–400 bed hospitals. Pre-submission scoring across 489 procedures, 24+ payers, 15 state regulatory environments. Under 60 seconds per claim. Works with Epic, Cerner, MEDITECH, and any EHR with a REST API.

For RCM partners: a white-label API behind your denial management product. FHIR R4, batch processing for 1,000+ claims, multi-tenant with client-level isolation. We sell through partners, not around them.

For pharma market access: drug-specific denial patterns, step therapy mapping, formulary positioning across 24+ payers and 15 states. 90-day brand pilots convert to annual contracts with a performance kicker on incremental revenue.

Six intelligence systems:

· Predictive Denial Analysis — payer medical director simulation
· Payer Decision Graph — 24+ payers, behavioral annotations
· Pre-Submission Scoring — five-factor weighted model
· Agentic Appeal Pipeline — 5 AI agents: medical, regulatory, financial, timeline, quality
· Temporal Intelligence — real-time payer behavior shifts
· Regulatory Leverage Engine — 15 states, live enforcement data

HIPAA-compliant. PHI sanitized before AI. 7-year audit logs. BAA ready. SOC 2 Type II audit in progress. 99.5% uptime SLA.

Start with the CPT lookup at coverageunlocked.com/enterprise. No form. Or email ned@coverageunlocked.com for a free 200-claim analysis of your current denials.

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