DenialOS Documentation
Docs / First denial
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First denial

Current intake routes support manual/text case creation and file-based intake for ERA/835, CSV, and universal source flows.

A safe first case workflow is:

Upload / create source
  ↓
Parsing and extraction
  ↓
Review source facts
  ↓
Create / confirm case
  ↓
Inspect denial reason and deadline
  ↓
Review evidence and missing information
  ↓
Prepare appeal/action
  ↓
Human approval

The system stores source and workflow history so an operator can distinguish what came from the source from what was derived or recommended.

AI drafting

Appeal drafting is a governed capability. Provider access requires a resolved security context, minimum-necessary context, an authorization decision, and an enabled AI capability. Human review is required by default.

Do not assume

A generated appeal is not evidence that a payer will accept it, and a drafted recommendation is not a submission authorization.