Guide
Agents
AI Tools
What Your Insurance Denial Letter Is Actually Saying
The reason code and the appeal deadline are buried on purpose. Find both first.
Claims and Denial Checker
Stop paying surprise medical bills blindly.Decode Insurance Denials Instantly.
Upload your document
Select a file or drop it here to start using Claims and Denial Checker.
Fight Insurance Denials in 3 Steps
Navigating the healthcare billing matrix is overwhelming. Let AI translate the jargon so you can take control.
Drop your Explanation of Benefits (EOB) or itemized hospital bill into our scanner.
The agent scans the messy grid of CPT codes, ICD-10 modifiers, and specific CARC denial codes.
Read why insurance didn't pay, and receive a strategy on how to file a successful appeal.
Medical Billing Translator
Your Confusing EOBs, Decoded.
Insurance companies rely on you not understanding the complex matrix of codes printed on your denial letter. Our agent is trained as a virtual medical biller, translating PR, CO, and OA codes into clear, actionable advice so you aren't left paying for mistakes.
assignment_lateIdentify Coding Errors
Detect if a denial was caused by a modifier or bundled CPT code.
hdr_autoTranslate Denial Codes
Turn obscure codes like "CO-16" or "PR-2" into plain explanations.
shelf_auto_hideDraft Appeal Frameworks
Get guidance on what documents to gather for a successful appeal.
UHC_Explanation_of_Benefits.pdfProcessed: Yesterday
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Why did insurance refuse to pay the $800 charge on page 2?
Looking at page 2, the $800 charge for CPT code 87081 was flagged with denial code CO-97. Here is what happened: The Issue (CO-97)CO-97 means “Payment adjusted because the benefit for this service is included in the allowance for another service/procedure.”
Your Next StepYou DO NOT owe this money. The “CO” stands for Contractual Obligation. The hospital billed incorrectly. Contact the hospital billing department and ask them to write off the bundled charge.
Your Next StepYou DO NOT owe this money. The “CO” stands for Contractual Obligation. The hospital billed incorrectly. Contact the hospital billing department and ask them to write off the bundled charge.
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Designed Explicitly for Healthcare Financials.
Generic AI bots hallucinate when dealing with dense medical billing matrices.
Our agent is engineered specifically to read EOB formats accurately.
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Responsibility Spotting
It quickly highlights the difference between the "Billed Amount," the "Allowed Amount," and what you are actually legally obligated to pay.
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Targeted Code Extraction
Whether it's a denial or an itemized surgery bill, our engines pull the exact PR (Patient Responsibility) and CO (Contractual Obligation) codes flawlessly.
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Save & Export Workflow
Keep a secure record of your analysis. Save active sessions to your Library to reference when on the phone with insurance reps, or copy the notes.
Built for Patients & Advocates
Turn confusing denial letters into a confident, actionable appeal strategy.
Patients with Denied Claims
Received a denial letter you don't understand? Ask the AI to decode the specific CARC codes and explain exactly why your insurance company refused to pay.
Patient Advocates & Navigators
Helping a client navigate a massive hospital bill? The agent can identify duplicate charges, unbundled codes, and services that should have been covered.
Self-Pay & Uninsured Patients
Reviewing an itemized hospital bill? Let the AI flag incorrect charges, out-of-network billing errors, and overcharges before you pay a cent.
Financial Data Privacy
Your Medical Financials Stay Private. Guaranteed.
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No AI Training
Your documents are strictly used for your session and never fed into public LLMs.
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256-Bit TLS
Data in transit and at rest is protected with bank-grade encryption protocols.
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Auto-Deletion
Files are permanently wiped from our servers within 15 min of your session ending.
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SOC-2 Ready
We comply with global privacy standards to keep your confidential data safe.
Explanation of Benefits and medical bills contain highly sensitive Protected Health Information (PHI). That's why we built our billing AI agent on a zero-trust, privacy-first architecture.
Unlike free consumer tools that scan your documents to train their models (risking data breaches), Fynepdf guarantees your documents remain strictly yours. Vet your bills with absolute confidence.
Read our full Security Policy.
Frequently Asked Questions
Will this tool automatically write my appeal letter?
The AI provides the structural framework, the correct billing terminology, and the exact reason for the denial. While it can draft a template for your appeal letter, you will need to fill in specific personal details and attach any supporting medical records it suggests before submitting it to your insurance provider.
Does it work with Medicare and standard insurance carriers?
Yes. The agent is trained on standard ANSI 835 claim payment structures and standard EOB formats. It can effectively read and translate documents from Medicare, Medicaid, UnitedHealthcare, Blue Cross Blue Shield, Aetna, Cigna, and most regional carriers.
Can it tell me if a hospital overcharged me?
Yes! By comparing your itemized hospital bill with your EOB, the AI can help identify instances of 'unbundling' (billing separately for things that should be grouped together) or upcoding, helping you spot discrepancies where a hospital may be charging more than the allowed insurance contract rate.
Can I use FynePDF for free without paying?
Yes. FynePDF is free to use with no feature restrictions, only file size and usage limits based on your plan. You can use our tools without creating an account, although signing up lets you save files and access your history. If you need larger file limits, higher monthly quotas, team features, or API access, you can upgrade to Professional, Premium, or Enterprise plans.
How secure are my files and data on FynePDF?
Your privacy and security are a top priority. All file transfers are protected with SSL/TLS encryption, and uploaded files are automatically deleted from our servers after 15 minutes unless you choose to save them to your personal library. Files are stored on AWS S3 with enterprise-grade encryption, and we never read, sell, or share the contents of your documents.
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