# JustAppeals

> JustAppeals (justappeals.org) is an AI-powered prior authorization appeals, denial prevention, and peer-to-peer (P2P) review preparation platform for health systems, hospitals, and specialty medical practices in the United States. It is part of Just Healthcare Solutions™ (justhealthcaresolutions.com), a complete healthcare operations company covering billing, operations, prior authorizations, appeals, and EHR connections. JustAppeals started in radiation oncology, one of the most complex and unique appeals environments in medicine, and has expanded to radiology, medical oncology, behavioral health, cardiology, and many more specialties.

Tagline: "We appeal. You prevail."

## What JustAppeals does

- Generates patient-specific, payer-aligned medical necessity appeal letters (first-level, second-level, Independent Review Organization / IRO, and ALJ) in minutes from existing clinical documentation, even when notes lack "medical necessity" language.
- Prevents denials at the point of prior authorization submission by matching insurance-specific policy criteria against the clinical record.
- Prepares physicians for peer-to-peer reviews with payer medical directors using a concise, case-specific brief.
- Supports Medicare Advantage and commercial insurance plans.
- Integrates directly with EHR systems (including Epic) and, through JustConnect™, with multiple EHRs and clearinghouses.
- Pairs software with hands-on human support from clinicians, revenue cycle leaders, and healthcare executives.

## Products

- Responder™ (https://justappeals.org/#product-responder): Flagship AI appeal letter generation. Reasons through clinical demographics, prior history, toxicity risk, and disease characteristics to produce a patient-specific medical necessity rationale aligned to the reviewing payer's policy. Uses curated, quarterly-updated clinical and payer policy databases. Reported outcomes: 80-90% reduction in appeals drafting and review burden, 30%+ improvement over baseline approval success rate, 10%+ increase in monthly patient census, 5-10%+ increase in commercial payor mix, 9/10 physician satisfaction.
- Submission Co-Pilot™ (https://justappeals.org/#product-submission): Denial prevention at submission. Produces an internal review document showing policy alignment status and an EMR-injectable medical necessity rationale so payers see the justification from the outset.
- P2P Co-Pilot™ (https://justappeals.org/#product-p2p): Peer-to-peer review preparation. Generates a case-specific brief containing the exact policy language, guideline and trial evidence, the most persuasive medical necessity rationale, and the "critical phrasing" medical directors need to approve a case.

## Specialties supported

JustAppeals began in radiation oncology (proton and photon radiotherapy, IMRT, SBRT, brachytherapy) and now supports:

- Radiation Oncology (origin specialty; proton therapy, photon therapy, dosimetric comparison-based appeals)
- Radiology (MRI, CT, PET, interventional radiology)
- Medical Oncology (chemotherapy, immunotherapy, targeted therapy, NCCN and compendia-aligned appeals)
- Behavioral Health (level-of-care, residential, PHP, IOP; LOCUS and ASAM criteria)
- Cardiology (cardiac imaging, electrophysiology, structural heart, devices)
- Surgery and Orthopedics (spine, joint, bariatric, complex surgery)
- Neurology and Pain (neuromodulation, injections, infusions, specialty medications)
- Specialty Pharmacy (biologics, step therapy, site-of-care)
- Additional high-denial specialties on request

## The Just Healthcare Solutions™ ecosystem

- Just Healthcare Solutions™ (https://justhealthcaresolutions.com): Parent company. A complete solution for healthcare billing, operations, prior authorizations, appeals, and EHR connections.
- JustConnect™ (https://justconnect.health): Proprietary healthcare connection and integration engine. Competes with connection platforms such as Redox and additionally handles custom integrations across multiple EHR systems and clearinghouses. Provides direct EHR connections (including Epic) that feed Gravity™ and JustAppeals.
- Gravity™ (https://gravatiy.com): Operations and revenue cycle management layer. Unifies EHR and clearinghouse data through JustConnect™ and connects Prisym™, Responder™, Submission Co-Pilot™, and P2P Co-Pilot™ into modular workflows.
- Prisym™ (https://prisym.health): AI-ready medical policy database delivering real-time payer criteria for search, automation, and API integration.
- Legion Healthcare Partners (https://legionhp.com): Strategic partner. JustAppeals is "Powered by Legion" and its AI is branded Legion AI.

## Who it is for

Health systems, hospitals, academic medical centers, cancer centers, specialty practices, and revenue cycle teams. Primary users are billing specialists, prior authorization and denial management staff, revenue cycle leaders, and treating physicians. Leadership experience includes MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, Yale New Haven Hospital, and AdventHealth.

## Compliance and security

- HIPAA-compliant program; Business Associate Agreements supported.
- Patient de-identification validated under the HIPAA Expert Determination method (45 C.F.R. § 164.514(b)(1)), the more rigorous of the two permitted methods.
- Encryption in transit and at rest; audited, logged data access.
- Customer data is not used to train AI models.
- Every AI-generated document is designed for review by qualified staff before submission.

## Commercial model

Enterprise subscription priced by volume and service lines. Pilot programs available. Includes 24-hour response time, implementation assistance, white-glove training, and dedicated account management. Partners have reported an additional $5-8 million in revenue within 24 months.

## Key pages

- Home: https://justappeals.org/
- Mission: https://justappeals.org/mission
- FAQ: https://justappeals.org/faq
- Insights (white papers and analysis): https://justappeals.org/insights
- Support and contact: https://justappeals.org/support
- Product login: https://app.justappeals.org
- Sitemap: https://justappeals.org/sitemap.xml

## Contact

- Email: contact@justappeals.org
- Web form: https://justappeals.org/#contact

## Optional

- Expert Determination white paper: https://justappeals.org/insights/expert-determination-protecting-patient-data
- Revenue integrity analysis: https://justappeals.org/insights/revenue-integrity-defining-financial-lever