Classify the packet
Identify and organize documents across the appeal packet, creating a structured foundation for review.
Demonstration stageAI products for regulated environments
Better evidence.
More confident appeals.
Appeals Agents helps healthcare organizations turn complex appeal packets into structured, traceable evidence—so reviewers can work faster without losing human judgment.
Demonstration-stage product • Designed for customer-specific implementation
Appeal evidence workspace Human review ready
01
Packet classifiedDocuments organized by type
Complete02
Evidence summarizedClaims linked to source material
Complete03
Gaps surfacedMissing or conflicting evidence flagged
Review< 10 minCurrent demonstration target for summary and gap identification
The cost of waiting
Healthcare appeals move slowly. The consequences do not.
Appeal decisions can take 45–90 days. During that time, hospitals and physicians wait for cash flow, reviewers search across fragmented documents, and patients may face delays in care.
The most demanding work is also the most consequential: reviewing submitted records, comparing evidence with benefits and policies, and following up on missing information.
Appeals Agents
From document volume to review-ready evidence.
A specialized, human-centered agentic workflow that helps teams understand what was submitted, what the evidence supports, and what still needs attention.
Build the evidence view
Extract and summarize material facts with links back to the supporting source evidence.
Demonstration stageSurface documentation gaps
Flag missing, incomplete, or conflicting information for focused human review.
Demonstration stageCompare with policy
Bring policy-aware reasoning into the workflow to support consistent review.
In developmentSupport recommendations
Present an explainable recommendation for an authorized reviewer to evaluate.
In developmentLearn through assurance
Evaluate quality, traceability, reliability, and operational behavior before broader use.
Being validatedHow it works
Automation where it helps. Human authority where it matters.
The workflow is designed to augment appeal professionals—not remove accountability from consequential decisions.
- 01
Ingest
Receive the appeal packet and establish a traceable case record.
- 02
Understand
Classify documents, extract evidence, and produce a grounded summary.
- 03
Evaluate
Highlight gaps and prepare policy-aware findings for review.
- 04
Decide
Enable an authorized human reviewer to assess the evidence and take action.
Built around the people doing the work
One evidence foundation. Multiple stakeholders.
Initial work is focused on U.S. government healthcare and the organizations that participate in its appeals ecosystem.
Federal and state agencies
Strengthen consistency, transparency, and oversight across high-volume appeal operations.
MACs and health plans
Help review teams organize evidence, identify gaps, and support defensible decisions.
Hospitals and physician groups
Prepare stronger appeal records and reduce time spent navigating fragmented documentation.
Revenue cycle organizations
Scale appeal preparation with repeatable workflows and evidence-level traceability.
Product focus
NowMedicaid financial appeals
NextEvaluation & Management
ThenSurgical appeals
Trust by design
Evidence for the system—not just answers from it.
VerityArc’s direction is to build AI products that can be evaluated, observed, governed, and improved within regulated enterprises.
01
Traceable
Connect summaries and findings to the evidence that supports them.
02
Human governed
Keep authorized professionals in control of consequential decisions.
03
Measurable
Evaluate quality, reliability, risk, and operational performance.
04
Built for regulated environments
Pursue alignment with applicable federal policy and recognized security, privacy, and AI risk frameworks as the company and product mature.
Our current posture
VerityArc is an early-stage company developing its compliance program. SOC 2 Type II, ISO 27001, HIPAA readiness, NIST alignment, and Six Sigma quality are targets and guiding frameworks—not current certifications or guarantees.
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SOC 2 Type II
Security & controls
Program target -
ISO 27001
Information security
Program target -
HIPAA readiness
Health data privacy
Readiness target -
NIST alignment
Risk & governance
Alignment goal -
Six Sigma quality
Continuous improvement
Guiding methodology
VERITY
ARC
ARC
About VerityArc
Advancing Human Life. Continuously.
“Verity” is rooted in truth. “Arc” reflects a deliberate path toward a north star. Together, they express our ambition: build advanced products that improve human outcomes with rigor, responsibility, and continuous learning.
VerityArc is an enterprise product company first and an AI consulting company second. Appeals Agents is the first product in a broader vision spanning regulated industries.
75+ yearsCombined healthcare experience across the founding team and contributors
Team members have experience delivering production-grade AI solutions in federal and private-sector roles. Those engagements were completed independently of VerityArc.
Start a focused conversation
Bring us an appeal workflow worth improving.
We are looking for pilot partners who want to evaluate Appeals Agents against real operational goals—processing time, financial outcomes, quality, and the number of patients and providers served.